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SDK125 > 3. Alcohol and Human Health > Flashcards

3. Alcohol and Human Health Flashcards

1
Q

What is another term for drunkenness?

A

Intoxication, from the Latin toxicum, a poison (as in toxic)

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2
Q

A litre can be divided into…

A

100 centilitres (100 cl) or 1000 millilitres (1000 ml)

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3
Q

If 12% of a 75 cl bottle of wine is pure alcohol, what is the volume of pure alcohol in the bottle?

A
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4
Q

What volume of pure alcohol would you consume if you drank half a litre of beer with an alcohol content of 5%? Express your answer in millilitres (ml).

A
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5
Q

What is binge drinking?

A

‘drinking to get drunk’

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6
Q

What is alcoholic poisoning?

A

Intoxication so extreme that it leads to unconsciousness that can result in death

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7
Q

What is alcoholic liver cirrhosis?

A

A chronic effect on individuals who regularly abuse alcohol.

The liver is so damaged by prolonged excessive consumption of alcohol that scar tissue replaces a large proportion of its normal structure. This severely impairs the liver’s ability to remove toxic substances (including alcohol) from the blood.

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8
Q

What is the chemical name of alcohol?

A

Ethanol

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9
Q

What are the two main types of chemical bonding?

A
  1. Covalent bonding
  2. Ionic bonding
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10
Q

What is ionic bonding?

A

An atom can lose an electron (sometimes more than one) which is itself donated to the atom of another element.

The atom receiving the electron becomes negatively charged. This process of electron loss or donation is referred to as ionisation and the charged particles formed are known as ions.

The ions now have equal and opposite electrical charges and so attract one another and it is this electrical attraction which holds the salt crystals together.

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11
Q

What is covalent bonding?

A

An outer electron from each of two adjacent atoms is shared between the two atoms, forming an electron­pair bond.

This type of bonding is called covalent bonding.

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12
Q

What is the chemical formula and how does a structural fomula look like (for water)?

A

Chemical formula: H2O

Structural formula: H-O-H

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13
Q

What is the chemical formula of ethanol?

A

C2H5OH

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14
Q

What is a -OH-part in a molecule called?

A

Hydroxyl group

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15
Q

Explain the electrical charge of the atoms in a water molecule.

A

The oxygen is slightly negatively charged, and the hydrogen atom it is attached to slightly positively charged.

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16
Q

Why does NaCl dissolve in water?

A

Sodium chloride contains Na+ ions and Cl− ions.

The slightly negatively charged end of the water molecule – the O atom – is attracted to the positively charged Na+ ion, and each Na+ ion becomes surrounded by a sphere of water molecules which encapsulate it.

The two ions (Na+ and Cl−) are now effectively separated from each other by the water molecules, and can act independently – this is the process of dissolving, and it is shown in the short animation below.

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17
Q

Why does ethanol dissolve in water?

A

Because in both molecules there are –OH (hydroxyl) groups with uneven concentrations of electric charge, and so the molecules are weakly attracted to each other.

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18
Q

Some atoms are better at attracting electrons to themselves than others: oxygen is one of these, and it is said to be…

A

electronegative

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19
Q

What is hydrogen bonding?

A

Hd+ of one molecule is attracted to the Od- of a neighbouring molecule.

The separation of charges on the -OH groups of both ethanol and water molecules means that these two molecules also form weak hydrogen bonds with each other, and so ethanol dissolves in water

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20
Q

What means BAC?

A

Blood-alcohol concentration

It is usually quoted in mg/100 ml of blood.

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21
Q

Ethanol is metabolised (broken down) in the liver in three stages. Which are those?

A
  1. ethanol → acetaldehyde
  2. acetaldehyde → acetic acid
  3. acetic acid → CO2 and + H2O
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22
Q

What is also needed for the metabolism of ethanol in the liver?

A

Enzymes

An enzyme is a molecule that has the ability to accelerate a particular chemical reaction in a cell, allowing it to take place at body temperatures.

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23
Q

Molecules such those enzymes, which make a reaction go faster but which can be recovered unchanged at the end of the reaction, are known as…

A

Catalysts

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24
Q

Which enzyme is needed for ethanol to convert into acetaldehyde?

A

Alcohol dehydrogenase (ADH)

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25
Q

What is acetaldehyde and what does it cause in the body?

A

Acetaldehyde is the result of ethanol reacting with ADH. It is more toxic than ethanol and makes people feel sick.

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26
Q

Does ADH only exist in a single form?

A

No, there are different isoforms of ADH.

Which ADH isoforms are present in a particular individual depends on the genetic makeup of that person.

Two of the five types of ADH metabolise ethanol to acetaldehyde more rapidly, resulting in the accumulation of higher amounts of acetaldehyde and making a drinker who possesses these forms feel uncomfortable more quickly (Asian).

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27
Q

Which enzyme is needed for the second ethanol reaction, acetaldehyde → acetic acid?

A

Aldehyde dehydrogenase (ALDH)

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28
Q

What is the bond dissociation energy?

A

The input of energy needed to break a bond between two atoms.

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29
Q

How does the absorption process (into the bloodstream) work?

A

The absorption process involves the molecules that are released from the digested food passing through the wall of the gut and into the surrounding blood vessels.

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30
Q

What happens to food before passing into the small intestine?

A

They have to pass the pyloric sphincter, which is a muscular constriction which closes when food is present in the stomach, ensuring that food is sufficiently digested before it is released into the small intestine.

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31
Q

Which two possibilities/places are there for ethanol being absorbed?

A

Ethanol is absorbed into the blood at a greater rate through the wall of the small intestine compared with the wall of the stomach.

Therefore if ethanol is retained in the stomach (by the closure of the pyloric sphincter) it will be absorbed more slowly, but once the ethanol passes into the intestine it will be absorbed rapidly.

32
Q

If there is food in the stomach, what effect will it have on the speed with which the ethanol from a drink enters the bloodstream?

A

The presence of food in the stomach will delay the rate at which ethanol in the stomach enters the small intestine because the pyloric sphincter will be closed to retain the food.

33
Q

Why does absorption of food is much faster in the small intestine?

A

The surface area of the lining of this tube is greatly increased by the presence of numerous villi.

A larger surface area means absorption of nutrients can occur at a faster rate.

34
Q

Molecules of ethanol are not broken down in the gut, but…

A

They diffuse through the wall of the gut into the adjacent blood vessels.

35
Q

Blood is transported around the body in pipes known as blood vessels. Which types are there?

A

Large vessels that carry blood away from the heart are known as arteries.

Large vessels that carry blood towards the heart are veins.

The arteries and veins branch into a network of tiny capillaries that infiltrate all of the tissues of the body.

36
Q

The small blood vessels that carry blood away from the gut converge to form a large vein. What’s the name?

A

Portal vein, which leads directly to the liver where some of the ethanol is removed.

37
Q

The blood vessels themselves are affected by the presence of ethanol in the blood. How?

A

The skin becomes warmer and flushed due to an effect called vasodilation.

The narrow blood vessels immediately beneath the skin dilate – they get wider so they carry more blood.

  • This mechanism, together with sweating, is normally used as a way of cooling the body when it is too hot:*
  • more flow of blood under the surface of the skin - more cooling can occur- heat can escape.*
38
Q

Is an alcoholic drink a good way to warm someone up on a cold evening?

A

An alcoholic drink might indeed make a cold person feel warmer as their skin will warm up due to vasodilation, but it would increase their actual loss of body heat to the environment, so their core body temperature would fall.

39
Q

Why will ethanol affect some organs sooner than others?

A

The rate at which ethanol leaves the blood and enters the organs is dependent upon how rich the blood supply is to the particular organ.

Organs with a particularly rich blood supply include the brain and the lungs, so ethanol will tend to affect these organs sooner than others.

40
Q

If a man and a woman of identical weight each simultaneously drank two glasses of wine, what would you expect to observe if you measured their blood-ethanol concentration 1 hour later and why?

A

The blood-ethanol concentration would be higher in the woman than the man. The woman has a smaller volume of water-based tissues for the ethanol to dissolve in than the man because a higher proportion of her body weight is fat.

(very little ethanol diffuses into fatty tissue because ethanol is more soluble in water than it is in fat)

41
Q

The liver plays an important role in a number of body functions, including:

A

digestive processes, regulation of blood glucose levels, storage of vitamins and the destruction of noxious substances (like ethanol)

42
Q

All of the blood from the portal vein, complete with any absorbed nutrients or other substances (ethanol, toxins, drugs, etc.) passes through the liver before reaching the general circulation.

What advantage and what risks can you see in this arrangement of the blood flow to the liver?

A

While this arrangement means that the liver can efficiently process absorbed substances such as ethanol and other toxins, it also means that the liver is exposed to higher concentrations of ethanol than any other organ.

43
Q

What means excretion?

Which is the most important organ for it?

A

The kidneys are responsible for excretion of waste substances from the blood through the production of urine.

Excretion = separation of waste products from the blood

44
Q

Each kidney contains around a million structures known as …. which filter the blood and produce the urine.

A

nephrons

45
Q

The brain secrets a special hormone when it detects decreased water levels. Which hormone is this?

A

Vasopressin

46
Q

Vasopressin travels to an organ. Which one and what does it do there?

A

Vasopressin travels to the kidneys after detection of decrease in water levels.

It then increases the ability of the cells in the nephrone tubes to move more water from within the tubules back to the bloodstream.

= reduction of amount of water lost in urine

47
Q

What happens to the vasopressin-kidney-interaction when ethanol is in the body?

A

Ethanol inhibits the release of vasopressin.

So: Increases amount of water lost in the urine

= dehydration

48
Q

What is a ‘reward’ (in evolutionary terms)?

A

A reward is something that animals, including humans, strive to obtain and will invest effort in gaining.

A ‘natural reward’ refers to such things as food, water and sex, as distinct from such ‘unnatural rewards’ as alcohol.

49
Q

What are recreational drugs?

A

Drugs like alcohol, unnatural rewards

They exhibit some similar properties to natural rewards in terms of the desire to obtain them, some of their effects on the brain, and the tension created when access is denied.

50
Q

What is a reinforcer (in psychology)?

Is alcohol one?

A

In psychology, a reinforcer refers to a factor that strengthens a tendency to engage in a particular behaviour.

The tendency to drink alcohol is increased by its anxiety-lowering effects in the past. Alcohol can lower painful self-consciousness, hence improving one’s own self-image.

51
Q

What is alcohol myopia?

A

Myopia means literally ‘short-sightedness’.

By analogy, the term ‘alcohol myopia’ indicates alcohol’s effect in inducing ‘psychological short- sightedness’. Alcohol lowers the range of attention. It gives a bias in favour of attending to immediate internal and external cues and against considering more remote events.

52
Q

Which two chemicals are most important when it comes to the neurotransmitters and ethanol?

Which one is excitatory?

A

GABA and glutamate.

Glutamate is excitatory

GABA is inhibitory

53
Q

Ethanol is an antagonist to glutamate.

How will this affect the activity of a postsynaptic neuron?

A

By antagonising excitatory glutamate, ethanol decreases the action potential frequency in this case.

54
Q

Ethanol is an agonist to GABA.

How will this affect the activity of a pre/postsynaptic neuron?

A

By attaching to sites at a presynaptic neuron that employs GABA, ethanol triggers the release of GABA, and by attaching to sites on the postsynaptic neuron, ethanol boosts the actions of GABA.

As GABA is an inhibitory neurotransmitter, the frequency of action potentials decreases even more.

55
Q

What is the activity in the prefrontal cortex (PFC)?

A

The activity of neurons there is associated with voluntary control of behaviour (self-control) and restraint.

56
Q

What does ethanol cause in the PFC?

A

Mild to moderate doses of alcohol selectively lower the activity of neurons in the PFC.

= People who are intoxicated with alcohol are less restrained

57
Q

Stimuli associated with natural rewards, such as the sight of food when hungry, tend to excite a group of neurons in the brain that…

A

use dopamine as their neurotransmitter.

58
Q

What does ethanol do with dopaminergic neurons?

A

By its chemical action on the dopaminergic neurons in this pathway, ethanol increases their activity, leading people to seek rewards more actively.

59
Q

Ethanol has a number of effects in the brain that reinforce each other to increase the tendency to engage in sexual behaviour.

Can you suggest two of these?

A
  1. Ethanol excites the dopaminergic neurons, which cause a person to seek rewards (in this case sex).
  2. Ethanol can also reduce the restraining activity of the prefrontal cortex.
60
Q

Name some characteristics of addiction.

A
  • craving: intense conscious occupation with thoughts of the object of the addiction)
  • dependence: addicts come to depend upon the drug for their ‘normal’ mental functioning
  • tolerance: over time, a need for an increasing amount of alcohol to obtain the same level of intoxication
  • withdrawal symptoms: characteristic physiological signs associated with a negative mood when the drug is not taken
61
Q

There are at least two psychological explanations (or ‘orientations’) for addiction. Which are these?

A
  1. exposure orientation: addiction arises simply

as a consequence of frequent use of a drug

  1. adaptive orientation: addicts try to use a drug to solve an emotional problem in their personal life
62
Q

What class of chemical intervention blocks the effect of a neurotransmitter?

A

antagonists

63
Q

What kind of drug could help against addictions?

A

The evidence points to neurons that employ neurotransmitters of the class termed opioids as forming the biological basis of reward and pleasure.

Therefore, if an intervention were able to disrupt synapses that employ opioids, maybe the attraction of alcohol could be reduced.

A drug of this class is naltrexone, which antagonises opioid neurotransmission.

64
Q

Another class of intervention is to try to create unpleasant consequences of drinking.

You met an example of such a drug in Section 2.4.1. Can you recall its name and how it acts?

A

The drug is Antabuse, which acts by preventing the conversion of acetaldehyde into acetic acid.

65
Q

If unusually high levels of acetaldehyde accumulate following an alcoholic drink, how could this have been caused by (a) the rate of reaction of an ADH isoform, and (b) the rate of reaction of an ALDH isoform?

A

ADH promotes acetaldehyde production

isoform with high rate = more acetaldehyde

ALDH ‘removes’ acetaldehyde

isoform with slow rate = more acetaldehyde

66
Q

Ethanol causes abdominal pain, nausea and vomiting during ‘hang over’. Why?

A
  • dehydration (vasopressin)
  • at a high concentration, ethanol damages cells on contact = irritation of the stomach and intestinal lining resulting in inflammation
  • ethanol also increases the production of gastric acid and intestinal secretions
67
Q

Name the three progressive stages of alcoholic liver disease.

A
  1. fatty liver
  2. hepatitis
  3. cirrhosis
68
Q

Explain the ‘fatty liver’.

A

  • early and reversible consequence of excessive alcohol consumption
  • fat accumulates within the cells of the liver (release of fats from adipose tissue)
  • reduced fat breakdown in the liver
  • in cases of chronic alcoholism other nutritional deficiencies play a role
69
Q

What is hepatitis?

A

Hepatitis means ‘inflammation of the liver’ and can range from being mild (only detectable through blood tests) to severe, causing sickness, jaundice (yellowing of the skin) and pain. Very severe hepatitis can lead to liver failure which is often fatal.

70
Q

What is cirrhosis?

A

Cirrhosis is a gradual and irreversible change in about 10% of chronic heavy­ drinkers whereby liver cells are replaced by scar tissue.

  • decrease the ability of the liver to perform its many essential biological functions
  • disrupts the blood flow through the liver tissue which causes serious complications such as damage to the spleen (an organ involved in blood maintenance) and the blood vessels of the gut (as blood pressure increases in the portal vein)
71
Q

Why does the disruption caused by cirrhosis affects many body systems?

A

Because the liver is responsible for many important functions, for example:

  • digestive processes
  • regulation of blood glucose levels
  • storage of vitamins
  • break­down of noxious substances
72
Q

Chronic consumption of high levels of alcohol can cause irreversible damage to the nervous system. For example:

A
  • dementia (loss of intellectual abilities due to shrinkage of brain tissue)
  • damage to the peripheral nerves (i.e. those connecting the central nervous system, CNS, with the rest of the body).

Symptoms: sensory disturbances (numbness or pain), motor disturbances (weakness and muscle wasting) and some problems with speech, swallowing, heart rate, pupil function, erectile function, breathing during sleep, etc.

73
Q

What is the fetal alcohol syndrome, FAS?

A

A disorder associated with maternal alcohol consumption during pregnancy.

FAS is defined by four criteria:

  1. alcohol consumption during pregnancy
  2. a characteristic pattern of minor facial abnormalities and other malformations (in particular of the limbs and heart)
  3. growth retardation
  4. central nervous system abnormalities
74
Q

The proportion of fat per body weight increases with age. How might this affect older drinkers?

A

The increased proportion of fat to muscle in older people will result in a decrease in total body water. As ethanol is water­soluble, the same amount of ethanol will be dissolved in a smaller amount of water, resulting in a higher BAC in an older person than a younger. Unless the body responds by making more enzymes, this will result in higher levels of intoxication after smaller amounts of ethanol.

75
Q

If the reaction catalysed by ALDH to form acetic acid is faster than the production of acetaldehyde (catalysed by ADH), how will this affect the drinker?

A

There will be no build­up of acetaldehyde because it will metabolise to acetic acid as soon as it is made. So, the drinker will not experience the flushing, increased heart rate, dizziness or nausea associated with a build­up of acetaldehyde.

76
Q

What is coronary heart disease (CHD)?

A

This condition occurs when the arteries supplying oxygen and nutrients to the heart muscle become blocked by fatty deposits known as plaques, and areas of heart muscle die as a result.

77
Q

What is a confounding factor?

A

Any factor which is statistically associated with a particular outcome (e.g. the incidence of a disease), but which is not involved in its causation.

The association is said to be ‘confounding’ because it can disguise the true cause (or causes) of the outcome.

SDK125 (7 decks)

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