Alcohol 2 Flashcards
Vaportini
High tech alternative appealing
Abrupt withdrawal can result in seizures and death
Still causes withdrawal and dependence
Still can be detected through breathalyzer/blood test
Hand Sanitizer Gel
Contains 5 shots
Practice of mixing it with Listerine to create a minty cocktail
Alcoholism
Chronic progressive disease that can be fatal
Primary disorder, not a side effect of another disorder
Effects nearly every cell in the body
Severity of disease is affected by genetics, culture, physiology, and response to stimuli
Little control of how frequently or how much they drink
Develops insidiously, with no clear line between problem drinking and alcoholism
Alcoholism Symptoms
Only sign may be unpleasant withdrawal after brief abstinence
Tolerance “ability to hold liquor”
Preoccupied with drinking, deny addiction, continue despite negative consequences
Drink early and often
Have history missing work or school due to hangover
Periodically quit drinking, but abstinence does not last long
Eventually dominates thoughts, emotions and actions
AUDIT
Alcohol Use Disorders Identification Test
<8, Low level of alcohol problem, no intervention needed
8-15, Simple advice focusing on reducing hazardous drinking
16-19- Brief counseling and continued monitoring
>20 Warrant further diagnostic evaluation for alcohol dependence
Molecular Basis of Alcoholism
10 major studies, % association with A1 allele ranges from 12-37%
Evidence suggests that A1 allele modifies clinical expression, but is neither a necessary nor sufficient cause for alcoholism
Epistasis– most likely explanation
Health Care costs
223.5 billion dollars spent on alcoholism
Korsakoff Syndrome
Chronic memory loss disorder caused by severe deficiency in thiamine
Commonly caused by alcohol misuse
Fetal Alcohol Syndrome
Profile of physical and behavioral abnormalities caused by alcohol drinking during first trimester of pregnancy
- growth retardation before and after birth
- facial abnormalities, small head small eyes
- abnormal behavior, mental retardation
Hangover
Set of symptoms that occur after drinking moderate to large amounts of alcohol in a short period of time
- 6 drinks male, 3-5 female
Headache, nausea, diarrhea, low appetite, shakiness, tired, (flu-like)
Precise cause unknown, thought to be multifaceted
Dose increases alcohol severity
Type of alcoholic beverage is important due to number of cogeners(impurities/chemicals that change odor, taste and color)
Body and cellular dehydration play a role due to inhibition of antidiuretic hormone
Sugar increases hangover
Benzodiazepine
Manage patients with a history of seizures
Manage alcohol withdrawal delirium
Valium, Ativan, Serax
Naltrexone (ReVia)
Opiate receptor antagonist
Alters the high of drinking
Drive to drink after first drink is reduced
lapse does not turn into a relapse
Most effective when combined with psychotherapy
Patients with high familial predisposition for alcoholism have lower levels of beta endorphin
Beta endorphin dramatically increases when drinking
Naltrexone has greatest efficacy within these families
First discovered in animal studies
Nausea combatted by taking in food or milk
CON
Must be opiate free and opiate analgesics won’t work well
Naltrexone (Vivitrol)
Injectable formulation of naltrexone
Naltrexone embedded in microsphere
380 mg per vial
Includes diluent and 20 gauge needle for Iim injection
Dosing lasts 30-40 days
No issue with medicine adherence, but must wait until it is metabolized for drug to be gone
Acamprosate (Campral)
Structurally similar to glutamate
Attenuates neuronal hyper excitability due to chronic alcohol intake and withdrawal
Anti-craving drug
Approved for use in 2005
Disulfiram (antabuse)
Irreversible inhibitor of aldehyde dehydrogenase
Causes massive buildup of acetaldehyde
Dysphoria, hypotension, flushing, nausea, vomiting, intense headache
Aversive effects from 1 drink
