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50 Cards in this Set
- Front
- Back
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Alcohol |
Ethyl Alcohol = alcohol - produced as a waste product of yeast |
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Alcohol Tolerance & Fluid |
More body fluid -> More diluted the alcohol If two people drank the same amount, the larger person would have more body fluids and thus have a lower BAC If a man and a woman drank the same amount, the man would have more body fluids and thus have a lower BAC |
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Alcohol Tolerance & Fat |
If two people weighed the same and drank the same amount, the person with more body fat would have less body fluids and thus a higher BAC If a man and a woman drank the same amount, the woman would have more body fat and thus less body fluids and thus a higher BAC |
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Metabolism of Alcohol |
Alcohol is converted into acetaldehyde by alcoholdehydrogenase Acetaldehyde is then converted into acetic acid by acetaldehyde dehydrogenase (ALDH) Alcohol----------------------Alcohol dehydrogenase--> Acetaldehyde----Acetaldehyde dehydrogenase--> Acetic acid |
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Metabolism of Alcohol |
Don't need to know the chemical formulas (You also get H2 from the first conversion. H2 and acetaldehyde cause bad symptoms) |
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Metabolism of Alcohol |
95% is metabolized by the liver 5% is excreted by the lungs (Breathalyzer measures this and calculates BAC) |
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Metabolism of Alcohol |
First Pass metabolism - occurs in the GI tract - more so in males Gastric alcohol dehydrogenase is about 60% more active in men, leaving a higher concentration of alcohol that will be absorbed more rapidly than women |
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Asian Flush Reaction to Alcohol |
~ 40% of Asians have genes that code for a less active form of ALDH than normal ~ 10% of Asians have genes that code for an inactive form of ALDH Alcohol consumption thus results in build-up of toxic acetaldehyde, causing flushing, headache, dizziness, nausea, vomiting, tachycardia, etc ~ 50% of Asians produce a facial flush after drinking small amounts of alcohol |
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Long Term Effects of Alcohol Caused by H2 |
1. Hypoglycemia – H2 prevents gluconeogenesis by causing the production of lactate instead of glucose 2. Lactic acidosis. Symptoms: gout (from uric acid), nausea, lethargy, low blood pressure, difficulty beathing, dizziness, weakness in arms and legs 3. Fatty liver 4. Hyperlipidemia - high levels of fat particles (lipids) in the blood stream 5. Ketoacidosis (symptoms similar to lactic acidosis without the gout) |
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Long-term Effects of Alcohol Caused by Acetaldehyde |
1. Cardiomyopathy (inhibits synthesis of proteins in heart muscle) 2. Interferes with the activation of vitamins by liver cells 3. Effects in brain (physical dependency, neurotoxicity, tendency toward alcoholism) 4.Hangover symptoms |
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Long-term Effects of Alcohol Caused by Acetaldehyde and H2 |
1. Alcoholic cirrhosis - damage of liver cells stimulates scar formation and blood vessels carrying oxygen are cut off 2. Portal hypertension – bleeding varices (dilated veins in the stomach or esophagus) and ascites (the accumulation of fluid in the peritoneal cavity, causing abdominal swelling) 3. Increase in ammonia in the blood –> hepatic coma (coma caused by liver problem) 4. Increase in bile in the blood – jaundice 5. Reduced blood proteins 6. Reduced ability of the blood to clot |
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Fetal Alcohol Syndrome |
Leading cause of non-heredity mental retardation Children who lack the facial features may still suffer from the psychological effects The greatest concern is the effects on the brain MRIs show effects on the frontal cortex, corpus callosum, cerebellum, basalganglia, hippocampus |
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Fetal Alcohol Syndrome |
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Fetal Alcohol Syndrome Causal Factors |
Don't know how much alcohol is needed to damage the fetus The pattern, amount, and stage of fetal development are all critical variables in determining the specific effects Alcohol use during the 4-9th weeks produces the most severe formative damage and severe mental retardation. |
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Alcohol Consumption During Pregnany |
The proportion of pregnant women drinking has quadrupled since 1991 (1 in 29) Any amount of alcohol is unsafe to drink while pregnant |
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Olney 2001 |
A single 4 hour episode of intoxication in baby rats will kill brain cells in many different parts of the brain (Born rats=3rd tri of human pregnancy) |
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Racial Prevalence of Fetal Alcohol Syndrome |
Native americans Blacks Whites Asians |
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Alcohol and Breast Cancer |
There is a dose-related increase in breast cancer caused by alcohol consumption Breast cancer risk increases by 40% from 2-4 drinks a day May result from the production of free radicals that damage breast tissue: Acetaldehyde is metabolized by both acetaldehyde dehydrogenase and xanthine oxidoreductase Xanthine oxidoreductase is found in breast tissue, and produces free radicals |
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Alcohol Psychological Effects |
Relaxation Reduces anxiety Decreases social inhibition - more gregarious, talkative, and friendly, or inappropriately outspoken Reduces judgment and increases confidence -> Increases risk-taking behaviors (such as unsafe sex) and increases sexual encounters |
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Alcohol and Aggression |
Alcohol use is associated with homicide, rape, and other violent activities, although the direct pharmacological effect of alcohol is less clear Taylor and Gammon, 1975: Low dose of alcohol inhibited aggression High dose of alcohol provoked aggression Other studies show that expectancy is also important. |
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Alcohol and Sexuality |
Both men and women think that alcohol will enhance sexual arousal and lower inhibitions. Physiological measures of sexual arousal decrease with increasing alcohol levels. However, reported subjective arousal was increased. Placebo: men were more aroused Increase in dose = increase in orgasm latency |
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Alcohol and Sexuality |
Both men and women think that if a member of the opposite sex has been drinking, they rate that person as being more interested in sex and more sexually available
Both men and women are more likely to have sex on a date when they drink on that date Alcohol myopia theory – more likely to attend to what is right in front of them |
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Alcohol and Body Temperature |
Alcohol increases blood circulation to the skin, causing a warm, flushing sensation
Alcohol results in poikilothermia – body temperature is affected more by the external temperature (If it's cold=you're cold. If it's hot=you're hot.) Body temperature drops (hypothermia) in the cold Body temperature increases (hyperthermia) in a hot environment |
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Alcohol and Memory |
Alcohol can lead to three different effects on memory: 1. Wernicke-Korsakoff syndrome 2. Alcoholic Blackout 3. State dependent memory |
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Wernicke-Korsakoff syndrome |
Severe anterograde amnesia (inability to remember any new information) Characterized by confusion and disorientation, tremors, poor coordination, and ataxia In later stages, the patient remembers the remote past, but almost nothing of what goes on around him Damage in the medial thalamus and the mammillary bodies of the hypothalamus (thiamine production) Thiamine treatment can stop the degeneration, but not reverse it. Once you've developed this syndrome it is irreversible. |
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Alcoholic Blackout |
Amnesia for events that occur during intoxication Can last hours or a day Reported by 25% of normal drinkers and 90% of alcoholics Based on retrospective reports obtained during sobriety Predictors: dose of alcohol, neglect of meals, gulping drinks, history of head trauma |
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State dependent memory |
Behavior learned while drunk cannot be remembered when sober, but is remembered when drunk Impairment of memory retrieval |
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Alcohol Effect on Sleep |
-Reduction in REM sleep -Sleep fragmentation (frequently becoming restless or waking up) -Sleep apnea (relaxes throat muscles) -During alcohol withdrawal: insomnia and REM rebound |
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Hangover |
Hangovers may a be sign of withdrawal or acute toxicity Symptoms: fatigue, headache, increased sensitivity to light and sound, tachycardia, tremor, dizziness, depression Begins when BAC is falling, and peaks when BAC is zero Predictors: BAC, congeners (Methadol main congener) (by-products from fermentation and distillation), personality (anxiety, anger, defensiveness). |
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Hangover Factors |
Contributing factors: -Dehydration (inhibits ADH) -Electrolyte imbalance -GI disturbances -Hypoglycemia -Sleep disturbances -Acetaldehyde |
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Alcohol Poisoning |
-Vomiting -Seizures -Slow and irregular breathing -Cold, clammy, bluish skin -Unconsciousness |
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Alcohol (Death) |
Death results from depression of the respiratory control center in the medulla If alcohol is consumed rapidly, lethal blood levels may be reached before the individual passes out. |
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Tolerance |
Tolerance: effects of alcohol are reduced when administered repeatedly. Cross Tolerance: Sedative–hypnotic class (including barbiturates and benzodiazepines) |
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The Four Kinds of Tolerance |
Acute Metabolic Pharmacodynamic Behavioral |
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Acute Tolerance |
Tachyphylaxis (Tolerance that occurs within a single dose) The effects are greater while BAC is increasing and smaller while BAC is decreasing Drinker’s perception of intoxication also undergoes acute tolerance (they feel less intoxicated while BAC is decreasing) This can lead individuals to risk driving while legally intoxicated, especially binge drinkers. |
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Metabolic Tolerance |
Increase in P450 liver microsomal enzymes that metabolize the alcohol Induction: when alcohol is consumed regularly, the MEOS enzymes increase,which increases the rate of metabolism of alcohol, and other drugs Induction is the basis for metabolic tolerance. |
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Pharmacodynamic Tolerance |
Neurons adapt to the continued presence of alcohol by making compensatory changes in cell function |
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Behavioral Tolerance |
Practicing behaviors while under the influence of alcohol allows adjustment and compensation Classical conditioning may also play a role |
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The 4 Stages of Alcohol Withdrawal |
1. Autonomic hyperactivity 2. Hallucinations 3. Seizures 4. Delirium tremens |
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Withdrawal: Autonomic hyperactivity |
Onset: 5-10 hours after cessation -Nausea -Vomiting -Tremors -Sweating -Rapid heartbeat -Hypertension -Anxiety -Loss of appetite |
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Withdrawal: Hallucinations |
Onset: 12-24 hours Duration: 2-6 days |
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Withdrawal: Seizures |
Onset: 12-28 hours Treated with benzos |
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Withdrawal: Delirium tremens |
5% make it to this stage -Disorientation -Confusion -Delusions -Amnesia -Loss of consciousness -Stroke -Heart attack |
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Pharmacotherapeutic Treatment for Alcoholism |
Includes two strategies: 1. Make drinking unpleasant 2. Reduce the reinforcing qualities of alcohol |
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Disulfiram (Antabuse) |
Inhibits ALDH Drinking any amount of alcohol results in flushing, pounding heart, nausea, vomiting, etc. (Gives you the Asian Flush Reaction) |
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Naltrexone |
Opioid receptor antagonist
Reduces alcohol consumption and craving and improves abstinence rates It is assumed that naltrexone reduces the positive feelings and subjective “high” by blocking the effects of alcohol-induced endorphin release |
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Other Drugs for Alcoholism |
Several other opioid receptor antagonists are also being tested Acamprosate acts as a partial antagonist at the glutamate NMDA receptor and significantly blocks the glutamate increase that occurs during alcohol withdrawal in rats. (makes withdrawal more tolerable so it's easier to quit?) |
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Vaillant, 1983 |
600 men studied for over 40 years Personality problems were the result of, not the cause of, alcoholism Heredity is important |
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Alcoholic Energy Drinks |
October, 2010 Students passed out after drinking Four Loco, and were hospitalized Contents: caffeine and alcohol Caffeine partially cancels the feeling of being drunk, but not the actual impairment |
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UK Testing of the Harms of Drugs |
In 2010, 20 drugs were scored on 16 criteria by experts Most harmful to individuals: Heroin, crack, meth Most harmful to others: Alcohol, heroin, crack Overall, alcohol was the most harmful drug |
