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73 Cards in this Set

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What amount of alcohol is considered 'moderate drinking'?
2 drinks/day for men, 1 drink/day for women.
What is considered a short-acting, weak sedatohypnotic?
Alcohol-->its short-acting causing it to have a bad withdrawal like the short-acting barbituates.
How many Americans suffer from Alcohol Use Disorders?
18 million
In every ten people, how many engage in high-risk drinking patters?
3 out of even 10 US adults.
How do you define 'binge drinking'?
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.
What 2 factors influenze alchol use and dependence?
-genetic (50%) and environmental (50%)
How does alcohol consumption affect the brain?
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.
What are the consequencers of adolescent alcohol abuse on the developing human brain.
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)
What is the relationship b/w alcohol use, nicotine, & cannabis?
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.
Compared to adults, who sensitive are adolescent to alcohol?
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.
What 5 factors does BAC depend on?
-Amt & alcohol concentration of beverage.
-Rate of drinking
-Food consumption & composition
-Gastric emptying & gastric metabolism
-Hepatic first pass
Where is alcohol absorbed?
Rapidly absorbed thru duodenum.
Do you need a lot of alcohol to get an effect?
What order kinetics is alcohol?
Zero order kinetics.
Some of the alcohol is destroyed by what enzyme in the stomach?
Alcohol dehydrogenase. (ADH)-->known as first pass metabolism. Solid food in stomach slows absorption of alcohol.
After a few drinks, does absorption rate increase or decrease?
What does carbonation do for alcohol absorption?
Passage of alcohol thru stomach may be facilitated by carbonation--like 'kick i' in champagne.
How does a high alcohol concentration affect diffusion/absorption?
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.
What are the gender difference in alcohol absorption for men and women?
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.
Does alcohol cross the BBB?
Yes, alcohol is evenly distributed in body fluid and crosses teh BBB and the placental barrier w/o difficulty.
How do you calculate BAL?
mg/100mL of blood
Define zero order kinetics.
Drugs that metabolize w/ zero order kinetics @ a constant rate regardless of the size of initial dose. (like alcohol!)
Where does most of alcohol get metabolised?
What is alcohol's elimination rate?
7 g/hr
What breaks down alcohol to acetaldehyde?
Alcohol dehydrogenase (usually not rate limiting)
What causes aldehyde dehydrogenase inhibition?
Accumulation of acetaldehyde is associated w/ what symptoms?
HA, gastritis, nausea, dizziness (hangover)--can also be from dehydration.
What happens when alcohol is being metabolized?
You generate a lot of hydrogens and get a lot of metabolic acidosis.
Polymorphism occurs at which 2 ADH loci?
ADH2 and ADH3
Why do 15% of African Americans have an increased alcohol metabolic rate?
B/c they have ADH 2*3 allele.
95% of White Americans have which ADH allele?
50% of Asians have which ALDH (aldehyde dehydrogenase) allele causing them to have decreased elimination of acetaldehyde & alcohol as well as a flushing response?
What is the rate limiting step of alcohol metabolism?
Alcohol dehydrogenase.
What is the Microsomal Ethanol-Oxidizing System?
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.
What CNS effects does alcohol have from depression of inhibitory control mechanisms in the brain?
Euphoria, impaired thought proceses, dec mechanical efficiency.
What is the MOA of ethanol?
Works on ion channels--especially by inhibiting glutamate-NMDA excitatory NT receptor & potentiating GABAa inhibitory NT receptor
What does chronic alcohol consumption induce?
Chronic ethanol consumption reduces GABA-mediated inhibition & abolishes ethanol potentiation
Ethanol inhibits or facilitates which receptors?
Ethanol inhibits: adenosine transporter & NE transporter
Ethanol facilitates: DA transporter & 5-HT transporter
What gives pregnant black-American women who drink while pregnant a protective effect against alcohol-related birth defects?
ADH2*3-->higher alcohol metabolism
Waht effects does ethanol have on the GABA system?
Interaction w/ GABAA receptor-->facilitation of GABA transmission-->activation of DA neurons in mesolimbic system--> sedative & anxiolytic effecgts, rebound hyperexcitability seen w/ withdrawal.
explain zero-order kinectics.
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
explain alcohol's first pass metabolism.
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
what two enzymes are responsible for metabolizing alcohol into its final waste product acetate?
alcohol --> ALCOHOL DEHYDROGENASE --> acetaldehyde (associated with headache, gastritis, nausea, hangover) --> ALDEHYDE DEHYDROGENASE --> acetate (eliminated in urine)
what drug will inhibit the breakdown of acetaldehyde --> acetate, thus working by inhibiting the enzyme aldehyde dehydrogenase?
what allele is associated with persons of asian decent that will cause a decreased elimination of acetaldehyde/alcohol/and flushing?
50% of asians have a polymorphism at the ALDH2 gene that depletes them of the enzyme aldehyde dehydrogenase
what is the rate-limiting step in alcohol metabolism?
alcohol dehydrogenase (ADH) - 1st and slowest step in breaking down EtOH
what enzyme is found mostly in the liver and increases in response to chronic ethanol exposure (which may attribute to tolerance).
MEOS - microsomal ethanol oxidizing system (also responsible for metabolizing barbituates)
how many drinks will it take you to get to a BAC of 0.08?
1 drink per 50lbs per hour to get a BAC of 0.08
what is a letal BAC?
BAC of 0.4 is normally lethal.
explain ethanol's MOA.
ethanol inhibits glutamate-NMDA excitatory neurotransmitter receptors and potentiates the GABAa inhibitory neurotransmitter receptor.
chronic alcohol intake will do what to ethanol's normal action on GABA?
chronic ethanol use will reduce the GABAa-mediated inhibition. the brain adjusts
what is ethanol's relationship with neurotransmitter release?
ethanol enhances dopamine release from the ventral tegmental area and teh nucleus accumbens; explaining the reward
name the two types of postsynaptic receptors and list examples of each.
1)LIGAND-GATED ion channels (fast): GABAa, glycine, glutamate, AcH (nicotinic) 2) METABOTROPIC RECEPTORS (slow): norE, GABAb, serotonin, dopamine, AcH (muscarinic), purinergic (adenosine)
what does alcohol do to blood vessels, sleep, and antidiuretic hormone?
dilates blood vessels; decreases REM, and inhibits ADH (reason for constant urinating while drinking)
when the BAL is rising what type of feelings to people have? what about when the BAL is falling?
RISING: stimulation, euphoria and elation; FALLING BAL: sedation, anger, and depression
at 60mg/100ml, what generally happens to a person's stance?
positive Romberg sway test
what is the term to describe the inability to convert short term into long term memory; it occurs in heavy drinkers.
what is the term to describe when you cannot remember events that happened while drunk but can remember then again if reminded?
greyout - this is likely a result of dissociation
at what BAL will driving performance be effected?
50-80mg/100ml of blood
functional MRIs will show a weakened connection between what two CNS structures?
frontal lobes and striatum
how long does it take to develop maximum tolerance?
few weeks; tolerance disappears in a couple of weeks if alcohol is taken away
define alcohol abuse.
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
repeated use of EtOH will cause tolerance to alcohol and cross-tolerance to what?
other drugs (sedatives)
if you combine alcohol with sedatives what will it do to the response and TI?
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)
name some signs of alcohol poisoning?
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
what is the final thing that will kill a person from alcohol poisoning?
respiratory failure
name some detrimental side-effects of alcohol use.
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
describe the facies of a fetal alcohol baby.
flat midface, short nose, thin upper lip, low nasal bridge, micrognathia (small chin), minor ear abnormalities, epicanthal folds
name this term that describes a chronic alcoholic with tremor, anxiety, tachycardia, delusions, and agitation. what do they have?
delirium tremens - this occurs when chronic alcoholics are suddenly deprived of alcohol - need to treat
what drug class do we treat alcohol withdrawal with?
benzodiazepines - helps to tx the tremors, tachycardia, hypertension and seizures
what drugs do we use to prevent drinking?
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
what is the name of the behavioral-psychosocial treatment that treats alcoholism as a disease model?
Alcoholics Anonymous
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.
acamprosate (used during withdrawl - decrease glutamate) - reason it works: chronic EtOH increases NMDA glutamate and Voltage dependent Ca2+ channels