Alcohol

Front 1

Pharmacokinetics: Absorption of Alcohol

Back 1

Absorbed readily in Duodenum.

Blood Alcohol Concentrationo (BAC) depends on:
-amount, rate, food, gastric metabolism, hepatic first pass.

Front 2

Distribution of Alcohol

Back 2

Volume of distribution = total body water.

Higher Fat = less water content and smaller volume for distribution of alcohol.

Women are affected more by alcohol in general.

Front 3

Metabolism of Alcohol

Back 3

1. Alcohol is convert by Alcohol Dehydrogenase (ADH) to Acetaldehyde. RATE LIMITING STEP.

2. Acetaldehyde is converted by Aldehyde Dehydrogenase (ALDH) to Acetate. Not rate limiting step unles ADH activity is high.

Front 4

Alcohol Elimination Rate

Back 4

7.0g/hr metabolism or 0.015% disappearance per hour.

Females eliminate faster than males.

Front 5

Alcohol Dehydrongenase Isoenzymes

Back 5

There are three ADH isoenzymes:
ADH1A, ADH1B, ADH1C.

Front 6

Aldehyde Dehydrogenase Isoenzymes

Back 6

There are two ALDH isoenzymes:
ALDH1, ALDH2

Front 7

Polymorphisms of ADHB and ADHC

Back 7

Mutations in ADH1B*2,ADH1B*3 and ADHC*1 result in rapid metabolism of alcohol and decreased risk in alcoholism.

Front 8

Acetaldehyde Toxicity

Back 8

Accumulation of Acetaldehyde associated with intense reactin to alcohol.

Headache, gastritis, nausea, dizzines (hangover).

ALDH2*2: decreased elimination gene. Less susceptibility to alcoholism.

Front 9

Why is alcohol tolerance important?

Back 9

Cross-tolerance to other depressant drugs can occur. Ex) BZ and Barb - will not work at normal doses during surgery in a secret alcoholic.

Front 10

Alcohol effect on GABA

Back 10

Interacts with GABA-A receptor and facilitates GABA transmission.

Binds to Serine270 of Receptor and increases Cl influx = hyperpolarization.

Front 11

CNS effects of Alcohol

Back 11

Sedative, Anxiolytic, Withdrawal.

Activates mesolimbic and mesocortical dopamine neurons (reward/pleasure center.)

Front 12

Chronic Alcohol effect on GABA

Back 12

Chronic use leads to less Cl influx and decreased GABA function.

Front 13

Effect of Alcohol on Opioid peptide System

Back 13

Activation of the opioid peptide system.
Reward: Mu
Aversion: Kappa
Craving.

Front 14

Alcohol as a Reinforcer

Back 14

Positive Reinforcment: pleasure, alter coonsciousness, conform to behavior of peers.

Negative Reinforcing: relieve stress and negative emotions, avoid withdrawal symptoms.

Front 15

Alcohol Effect on NMDA (Glutamate) System

Back 15

Blocks NMDA Glutamate System which contributes to sedative/hypnotic effects. Participates in withdrawal syndrome.

Front 16

Alcohol Toxicity

Back 16

General Cell Toxicant.

Inflammation and cancer of throat, esophagus, stomach, pancreas, small intestine, colon.

Pancreatitis, diabetes.

Front 17

Alcohol Liver Toxicity

Back 17

Supress vitamin function and appetite leading to malnutrition.

Inflammation and FAT deposits leading to alcoholic hepatitis and liver cancer.

Cell death and scar tissue leading to cirrhosis.

Front 18

Cardiovascular Toxicity

Back 18

High BP and atherosclerosis from liver FAT production.

Cariomyopathy.

Impairment of blood cell production (anemia and immune weakness).

Vasodilation and heat loss.

RBC clumping, poor circulation and capillary rupture/stroke.

Front 19

CNS Toxicity

Back 19

Impairs Judgement, VISION, coordination leading to accidnets.

Brain cell death leading to dementia.

Acute overdose leading to brain stem failure and coma/death.

Front 20

Disulfiram

Back 20

Alcohol drug.

Inhibits Aldehyde Dehydrogenase so acetaldehyde builds up in the body. Person has huge hangover.

Front 21

Naltrexone

Back 21

Newer Alcohol drug.

Opioid antagonist that reduces alcohol craving.

Reduces relapse in recover alcoholics.

Front 22

Acamprosate

Back 22

Glutamate antagonist, GABA agonist.

Decreases drinking behavior.

Front 23

Benzodiazepines

Back 23

Usefull in treating withdrawal symptoms.

Facilitates GABAergic function.

Compensates for reduced function in chronic alcoholics