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Alcohol Flashcards

1
Q

What is the compound known as drinking alcohol?

A

Ethanol

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2
Q

What is the most commonly detected and litigated drug in criminal cases?

A

Alcohol

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3
Q

Give examples of cases in which alcohol may play a role.

A

SA
Homicide
Assault
Impaired driving

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4
Q

What type of investigations does alcohol play an important role in?

A

Death

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5
Q

What units of measurement is blood alcohol concentration commonly reported in?

A

mg of alcohol in 100 mL of blood (mg/100 mL)
Often: 0.08g/100 ml
(numbers are just an example)

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6
Q

What is the legal BAC limit?

A

80 mg/100 mL
i.e., 0.08 g/100 mL

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7
Q

How does ethanol absorb?

A

By diffusion

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8
Q

What organs absorb ethanol?

A

25% through stomach, remainder through small intestine

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9
Q

What influences the rate of alcohol absorption?

A

Type of beverage and presence of food in stomach

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10
Q

How does food in stomach effect ethanol absorption?

A

Prolongs gastric emptying time (i.e., opening and closing of pylrous valve)
This delay will result in a lower peak BAC

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11
Q

Which organ primarily metabolizes alcohol?

A

Liver

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12
Q

How much of an ingested dose of alcohol is metabolized? What happens to the remaining amount?

A

96-98% metabolized
2-4% excreted in urine, breath and sweat

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13
Q

What is the primary enzyme responsible for alcohol metabolism?

A

Alcohol dehydrogenase

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14
Q

When might the rate of elimination of alcohol not remain constant?

A

If drinking pattern changes over long term (i.e., alcoholics)

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15
Q

Who are higher rates of alcohol metabolism observed in?

A

Chronic drinkers

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16
Q

What is the average elimination rate used for forensic purposes?

A

10-25 mg/100 mL/hour

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17
Q

Describe the pharmacological action of alcohol.

A

Simple molecule that readily crosses cell membrane including blood-brain barrier
Has specific and non-specific effects on CNS
Non-specific effects due to disturbing proteins in cell membranes

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18
Q

List the 3 non-specific effects of alcohol on neuronal membranes.

A
  1. Disturbs relationship of protein in membrane ‘2. Interacts with polar heads of phospholipids
  2. Alters lipid composition
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19
Q

List the 4 specific effects of alcohol on neuronal membranes.

A
  1. Acts at neurotransmitter binding site
  2. Modifies gating mechanism inside channel
  3. Interacts directly with channel protein
  4. Stimulates Gs, which is linked to adenylyl cyclase
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20
Q

What neurotransmitter systems does alcohol affect?

A

Virtually all

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21
Q

Describe the specific effects alcohol has on some neurotransmitters at lower concentration

A

Increases inhibitory effects of GABA receptors
Inhibits glutamate receptors
i.e., increases inhibitory transmission, decreases excitatory
Increases 5-HT neurotransmission
Stimulates DA transmission in the mesolimbic pathway

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22
Q

What effect does alcohol have on the CNS?

A

Is a CNS depressant

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23
Q

What is the initial effect of alcohol?

A

Disinhibition

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24
Q

What happens to the effects of alcohol as BAC increases?

A

Increase

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25
Which correlates well with BAC - impairment or gross physical signs of intoxication?
Impairment
26
What does intoxication refer to?
Visible signs of drunkenness
27
What is impairment?
Relates to changes in CNS function e.g., an increase in choice reaction time
28
What is often at issue at impaired driving trials?
Impairment vs. intoxication
29
Describe the effects of alcohol at 10-50 mg%.
Decreased inhibitions Increased talkativeness Euphoria Flushing of the faceD
30
Describe the effects of alcohol at 50-100 mg%
Novice and light drinkers may experience signs of slurred speech and impairment of fine motor coordination
31
Describe the effects of alcohol at 100-200 mg%
Moderate drinkers experience slurred speech, incoordination, even simple tasks exhibit impairment
32
Describe the effects of alcohol at 200 to 300 mg%.
Marked loss of coordination (stumbling), mental confusion, memory loss, marked sedation, coma
33
Describe the effects of alcohol at >300 mg%
Attributed to acute alcohol poisoning deaths
34
How high have BACs been detected in drinking drivers?
In excess of 500 mg%
35
What leads to alcohol tolerance?
Chronic use
36
What is alcohol tolerance?
Involves metabolic and behavioural changes Visible signs of intoxication are decreased
37
What is metabolic tolerance of alcohol?
Liver enzyme production increases Leads to increase in elimination rates
38
Describe functional tolerance of alcohol.
Alcohol abusers often modify behaviour in order to mask gross signs of intoxication
39
List some ways in which people may mask their intoxication.
Standing/walking with wider stance accommodates stagger Speaking slower and annunciating carefully to mask slurred speech
40
What are the two ways to estimate BAC?
Back projection Forward projection
41
What is back projection?
Calculates from a known alcohol concentration e.g., blood alcohol result or breath alcohol result to a previous point in time
42
What is required for back projection?
Elimination rate Time of incident
43
What is forward projection?
Calculates forward to a specific point in time or timeframe and is based on a number of factors.
44
What is required for forward projection?
Elimination rate Gender Weight Drinking history Time of drinking
45
What evidence can be used to prove consumption of alcohol?
CCTV videos Photos Bar receipts
46
What is included in a drinking history?
Knowledge of available drinks, alcohol percentage and volume
47
What are the different definitions of drinking behaviour?
Social Moderate Heavy
48
What are the recommendations made by CAMH for weekly drinking?
Women - 10 drinks/week, no more than 2 per day (most days) Men - 15 drinks/week, no more than 3 per day (most days)
49
How does the NIAAA define binge drinking?
Pattern of drinking leading to BAC greater than or equal to 80 mg%. 5+ drinks for men 4+ drinks for women in about 2 hours
50
How does SAMHSA define binge drinking?
5 + drinks for males, 4+ for women on the same occasion
51
How does SAMHSA define heavy alcohol use?
Binge drinking on 5 or more days in the past month
52
What is alcohol induced memory loss?
Periods of anterograde amnesia
53
Define alcohol induced memory loss
Amnesia for the events of any part of a drinking episode without loss of consciousness
54
How can it be difficult to tell if a blackout has occurred
If the person did not do memorable things
55
Describe the steps of memory formation
Encoding > storage > retrieval
56
Why might free recall be difficult after drinking?
Alcohol may disrupt processing of context for the formation of an episodic memory
57
What are the two types of memory loss?
En-bloc Fragmentary
58
What is en-bloc memory loss?
Usually permanent
59
What is fragmentary memory loss?
Occurs more frequently Recall can occur, often with various cues
60
What factors are associate with blackouts?
Large quantities of alcohol Rapid rise in BAC Drinking spirits Gulping drinks
61
What is knowledge of drug effects on psychomotor performance useful for?
Psychopharmacologists who conduct research on behavioural effects of psychoactive substances Clinicians who prescribe potentially impairing drugs Forensic toxicologists who want scientidic data from studies to support opinions
62
What types of measurement were used in the impaired driving study?
Divided attention Reaction time Logical reasoning Time estimation Vigilance Choice reaction time
63
What is risk-taking defined as?
Embarking on a task without certainty of success
64
Describe the study design for the impaired driving study.
Experienced bus drivers Average 45 years old Drinking history Abstinence to an average of 30 pints/week
65
Describe the risk assesment process in the impaired driving study.
Drivers sat in drivers seat and were told they were about to drive bus between two posts. had to tell investigators how well they think they could do. asked, how many times out of 5 could you drive through the post. The smallest gap they would attempt to drive through The actual performance
66
What were the results of the impaired driving study?
As BAC increased they were prepared to drive through a smaller gap As BAC increased they needed a wider gap to succeed Involvement in hazard increases as BAC increases
67

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