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73 Cards in this Set
- Front
- Back
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What amount of alcohol is considered 'moderate drinking'?
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2 drinks/day for men, 1 drink/day for women.
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What is considered a short-acting, weak sedatohypnotic?
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Alcohol-->its short-acting causing it to have a bad withdrawal like the short-acting barbituates.
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How many Americans suffer from Alcohol Use Disorders?
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18 million
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In every ten people, how many engage in high-risk drinking patters?
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3 out of even 10 US adults.
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How do you define 'binge drinking'?
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Pattern of drinking that brings BAC to 0.08% or above. For the typical adult, this is 5 or more drinks (male) or 4 or more drinks (female) in 2 hrs. Its dangerous for drinker and society.
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What 2 factors influenze alchol use and dependence?
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-genetic (50%) and environmental (50%)
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How does alcohol consumption affect the brain?
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The cortex stops growing @ 25 and many in their teens and early twenties consume large amounts of alcohol. The limbuc system governing emotions matures earlier than frontal cortex, responsible for planning, self-control, & decision making.
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What are the consequencers of adolescent alcohol abuse on the developing human brain.
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Binge-like drinking-->affects memory, alters sensitivity to motor impairment, & damanges frontal-anterior cortical regions.
-Prolonged ethanol exposure produces long-lasting neurophysiological changes in cortex & hippocampus (@ gene level) |
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What is the relationship b/w alcohol use, nicotine, & cannabis?
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There is a huge correlation b/w nicotine & alcohol users. Nicotine is a weak stimulant, alcohol is a sedatohypnotic, and marijauna most closely resebles alcohol.
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Compared to adults, who sensitive are adolescent to alcohol?
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Adolescents are less sensitve to some of the aversive effects of acute alcohol intoxication (sedation, hangover, ataxia), but more sensitive to alcohol's effects on:
social facilitation, disruption of spatial memory. |
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What 5 factors does BAC depend on?
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-Amt & alcohol concentration of beverage.
-Rate of drinking -Food consumption & composition -Gastric emptying & gastric metabolism -Hepatic first pass |
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Where is alcohol absorbed?
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Rapidly absorbed thru duodenum.
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Do you need a lot of alcohol to get an effect?
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Yes
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What order kinetics is alcohol?
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Zero order kinetics.
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Some of the alcohol is destroyed by what enzyme in the stomach?
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Alcohol dehydrogenase. (ADH)-->known as first pass metabolism. Solid food in stomach slows absorption of alcohol.
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After a few drinks, does absorption rate increase or decrease?
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Incease.
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What does carbonation do for alcohol absorption?
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Passage of alcohol thru stomach may be facilitated by carbonation--like 'kick i' in champagne.
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How does a high alcohol concentration affect diffusion/absorption?
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Diffusion rates of alcohol increases w/ inc concentration, but very high concentrations interferes w/ absorption by slowing rates at which stomach empties its contents into intestines.
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What are the gender difference in alcohol absorption for men and women?
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Women have lower levels of ADH in their stomach than men to break some of the alcohol down. Men also have more total body water b/c of the higher testosterone level.
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Does alcohol cross the BBB?
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Yes, alcohol is evenly distributed in body fluid and crosses teh BBB and the placental barrier w/o difficulty.
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How do you calculate BAL?
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mg/100mL of blood
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Define zero order kinetics.
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Drugs that metabolize w/ zero order kinetics @ a constant rate regardless of the size of initial dose. (like alcohol!)
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Where does most of alcohol get metabolised?
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Liver.
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What is alcohol's elimination rate?
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7 g/hr
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What breaks down alcohol to acetaldehyde?
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Alcohol dehydrogenase (usually not rate limiting)
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What causes aldehyde dehydrogenase inhibition?
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Disulfiram
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Accumulation of acetaldehyde is associated w/ what symptoms?
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HA, gastritis, nausea, dizziness (hangover)--can also be from dehydration.
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What happens when alcohol is being metabolized?
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You generate a lot of hydrogens and get a lot of metabolic acidosis.
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Polymorphism occurs at which 2 ADH loci?
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ADH2 and ADH3
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Why do 15% of African Americans have an increased alcohol metabolic rate?
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B/c they have ADH 2*3 allele.
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95% of White Americans have which ADH allele?
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ADH2*1
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50% of Asians have which ALDH (aldehyde dehydrogenase) allele causing them to have decreased elimination of acetaldehyde & alcohol as well as a flushing response?
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ALDH2
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What is the rate limiting step of alcohol metabolism?
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Alcohol dehydrogenase.
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What is the Microsomal Ethanol-Oxidizing System?
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Uses p450 system to metabolize alcohol. Handles 5-10% @ low blood levels. Its activity rises @ higher centers of blood alcohol accounting for 50-65% of inc alcohol metabolism inducing by heavy drinking, which partly accounts for alcohol tolerance. Also responsible for metabolism of other drugs like barbituates.
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What CNS effects does alcohol have from depression of inhibitory control mechanisms in the brain?
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Euphoria, impaired thought proceses, dec mechanical efficiency.
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What is the MOA of ethanol?
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Works on ion channels--especially by inhibiting glutamate-NMDA excitatory NT receptor & potentiating GABAa inhibitory NT receptor
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What does chronic alcohol consumption induce?
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Chronic ethanol consumption reduces GABA-mediated inhibition & abolishes ethanol potentiation
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Ethanol inhibits or facilitates which receptors?
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Ethanol inhibits: adenosine transporter & NE transporter
Ethanol facilitates: DA transporter & 5-HT transporter |
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What gives pregnant black-American women who drink while pregnant a protective effect against alcohol-related birth defects?
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ADH2*3-->higher alcohol metabolism
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Waht effects does ethanol have on the GABA system?
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Interaction w/ GABAA receptor-->facilitation of GABA transmission-->activation of DA neurons in mesolimbic system--> sedative & anxiolytic effecgts, rebound hyperexcitability seen w/ withdrawal.
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explain zero-order kinectics.
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a constant amount of drug is metabolized per unit of time regardless of a drug concentration; alcohol will be metabolized 1 drink per hour or about 10grams of EtOH an hour; aspirin and alcohol follow zero-order kinetics
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explain alcohol's first pass metabolism.
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alcohol follows first-pass metabolism. it begins it metabolism in the gut by alcohol dehydrogenase; the majority 90-98% is metabolized in the liver; both stomach and liver use the enzyme alcohol dehydrogenase (ADH is a NAD dependent enzyme that breaksdown alcohol at a fixed rate (zero-order) of 7-10g/hr
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what two enzymes are responsible for metabolizing alcohol into its final waste product acetate?
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alcohol --> ALCOHOL DEHYDROGENASE --> acetaldehyde (associated with headache, gastritis, nausea, hangover) --> ALDEHYDE DEHYDROGENASE --> acetate (eliminated in urine)
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what drug will inhibit the breakdown of acetaldehyde --> acetate, thus working by inhibiting the enzyme aldehyde dehydrogenase?
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disulfiram
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what allele is associated with persons of asian decent that will cause a decreased elimination of acetaldehyde/alcohol/and flushing?
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50% of asians have a polymorphism at the ALDH2 gene that depletes them of the enzyme aldehyde dehydrogenase
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what is the rate-limiting step in alcohol metabolism?
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alcohol dehydrogenase (ADH) - 1st and slowest step in breaking down EtOH
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what enzyme is found mostly in the liver and increases in response to chronic ethanol exposure (which may attribute to tolerance).
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MEOS - microsomal ethanol oxidizing system (also responsible for metabolizing barbituates)
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how many drinks will it take you to get to a BAC of 0.08?
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1 drink per 50lbs per hour to get a BAC of 0.08
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what is a letal BAC?
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BAC of 0.4 is normally lethal.
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explain ethanol's MOA.
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ethanol inhibits glutamate-NMDA excitatory neurotransmitter receptors and potentiates the GABAa inhibitory neurotransmitter receptor.
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chronic alcohol intake will do what to ethanol's normal action on GABA?
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chronic ethanol use will reduce the GABAa-mediated inhibition. the brain adjusts
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what is ethanol's relationship with neurotransmitter release?
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ethanol enhances dopamine release from the ventral tegmental area and teh nucleus accumbens; explaining the reward
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name the two types of postsynaptic receptors and list examples of each.
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1)LIGAND-GATED ion channels (fast): GABAa, glycine, glutamate, AcH (nicotinic) 2) METABOTROPIC RECEPTORS (slow): norE, GABAb, serotonin, dopamine, AcH (muscarinic), purinergic (adenosine)
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what does alcohol do to blood vessels, sleep, and antidiuretic hormone?
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dilates blood vessels; decreases REM, and inhibits ADH (reason for constant urinating while drinking)
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when the BAL is rising what type of feelings to people have? what about when the BAL is falling?
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RISING: stimulation, euphoria and elation; FALLING BAL: sedation, anger, and depression
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at 60mg/100ml, what generally happens to a person's stance?
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positive Romberg sway test
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what is the term to describe the inability to convert short term into long term memory; it occurs in heavy drinkers.
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blackout
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what is the term to describe when you cannot remember events that happened while drunk but can remember then again if reminded?
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greyout - this is likely a result of dissociation
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at what BAL will driving performance be effected?
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50-80mg/100ml of blood
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functional MRIs will show a weakened connection between what two CNS structures?
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frontal lobes and striatum
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how long does it take to develop maximum tolerance?
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few weeks; tolerance disappears in a couple of weeks if alcohol is taken away
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define alcohol abuse.
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in a 12 month period must have one of the following: 1 failure to carry out major obligations at work, home, or school; 2.repated use even when it is physically dangerous 3.repeated legal problems due to EtOH, 4. continued use despite knowing it has caused or worsened social or interpersonal problems
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repeated use of EtOH will cause tolerance to alcohol and cross-tolerance to what?
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other drugs (sedatives)
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if you combine alcohol with sedatives what will it do to the response and TI?
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increase the response and decrease the TI(ratio of drug's toxic dose/theraputic dose); it will take less time to kill you;;;;even combined, alcohol will still metabolize at 1 drink/hr (zero order)
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name some signs of alcohol poisoning?
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mental confusion, stupor, coma, no response to pinching, vomiting while asleep, seizures (knocked out GABA -opposite of MOA; burst of glutamate), bluish tint to skin, cold hands
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what is the final thing that will kill a person from alcohol poisoning?
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respiratory failure
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name some detrimental side-effects of alcohol use.
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alcoholic hepatitis--> cirrhosis (ascities-abdominal distention), korsakoff's syndrome (due to lack of B1/thiamine); FAS fetal alcohol syndrome, alcoholic cardiomyopathy, ulcers, CA, pancreatitis, volume depletion
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describe the facies of a fetal alcohol baby.
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flat midface, short nose, thin upper lip, low nasal bridge, micrognathia (small chin), minor ear abnormalities, epicanthal folds
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name this term that describes a chronic alcoholic with tremor, anxiety, tachycardia, delusions, and agitation. what do they have?
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delirium tremens - this occurs when chronic alcoholics are suddenly deprived of alcohol - need to treat
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what drug class do we treat alcohol withdrawal with?
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benzodiazepines - helps to tx the tremors, tachycardia, hypertension and seizures
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what drugs do we use to prevent drinking?
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Disulfiram (blocks aldehyde dehydrogenase enzyme); Naltrexone (injection-binds to opioid receptors and blocks craving/reward$$); acamprosate (in withdrawl)(blocks craving by decreasing the release of glutamate); Benzodiazepines, SSRIs
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what is the name of the behavioral-psychosocial treatment that treats alcoholism as a disease model?
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Alcoholics Anonymous
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name the drug that inhibits neuronal hyperexicitability by decreasing the release of glutamate and decreasing the post-synaptic excitability of glutamate. it inhbits Ca influx through NMDA glutamate receptors and voltage dependent ca channels.
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acamprosate (used during withdrawl - decrease glutamate) - reason it works: chronic EtOH increases NMDA glutamate and Voltage dependent Ca2+ channels
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