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50 Cards in this Set

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Ethyl Alcohol = alcohol - produced as a waste product of yeast

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

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

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

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)

Don't need to know the chemical formulas

(You also get H2 from the first conversion. H2 and acetaldehyde cause bad symptoms)

Metabolism of Alcohol

95% is metabolized by the liver

5% is excreted by the lungs (Breathalyzer measures this and calculates BAC)

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

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

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)

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

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 hypertensionbleeding 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

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

Fetal Alcohol Syndrome

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.

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

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)

Racial Prevalence of Fetal Alcohol Syndrome

Native americans




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

Alcohol Psychological Effects


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

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.

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

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

Alcohol and Body Temperature

Alcohol increases blood circulation to the skin, causing a warm, flushing sensation

Alcohol results in poikilothermiabody 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

Alcohol and Memory

Alcohol can lead to three different effects on memory:

1. Wernicke-Korsakoff syndrome

2. Alcoholic Blackout

3. State dependent memory

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.

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

State dependent memory

Behavior learned while drunk cannot be remembered when sober, but is remembered when drunk

Impairment of memory retrieval

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


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).

Hangover Factors

Contributing factors:

-Dehydration (inhibits ADH)

-Electrolyte imbalance

-GI disturbances


-Sleep disturbances


Alcohol Poisoning



-Slow and irregular breathing

-Cold, clammy, bluish skin


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.


Tolerance: effects of alcohol are reduced when administered repeatedly.

Cross Tolerance: Sedative–hypnotic class (including barbiturates and benzodiazepines)

The Four Kinds of Tolerance





Acute Tolerance


(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.

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.

Pharmacodynamic Tolerance

Neurons adapt to the continued presence of alcohol by making compensatory changes in cell function

Behavioral Tolerance

Practicing behaviors while under the influence of alcohol allows adjustment and compensation

Classical conditioning may also play a role

The 4 Stages of Alcohol Withdrawal

1. Autonomic hyperactivity

2. Hallucinations

3. Seizures

4. Delirium tremens

Withdrawal: Autonomic hyperactivity

Onset: 5-10 hours after cessation





-Rapid heartbeat



-Loss of appetite

Withdrawal: Hallucinations

Onset: 12-24 hours

Duration: 2-6 days

Withdrawal: Seizures

Onset: 12-28 hours

Treated with benzos

Withdrawal: Delirium tremens

5% make it to this stage





-Loss of consciousness


-Heart attack

Pharmacotherapeutic Treatment for Alcoholism

Includes two strategies:

1. Make drinking unpleasant

2. Reduce the reinforcing qualities of alcohol

Disulfiram (Antabuse)

Inhibits ALDH

Drinking any amount of alcohol results in flushing, pounding heart, nausea, vomiting, etc.

(Gives you the Asian Flush Reaction)


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

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?)

Vaillant, 1983

600 men studied for over 40 years

Personality problems were the result of, not the cause of, alcoholism

Heredity is important

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

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