Alcohol Flashcards
BAC 0.03
Slight euphoria
0.06
warmth
relaxation
euphoria
0.09
Noticeable behaviour impairment
0.12
Substantial impairment
0.19
Gross motor impairment
0.2
Vomiting
Trouble walking
0.25
Blackouts
0.3
Passed out
0.35
Coma
0.45
death
How is alcohol formed
Conversions of sugar into cellular energy
Fermentation
One molecule of glucose acted on by yeast in the presence of heat and the absence of oxygen – produces 2 ethanol and 2 carbon dioxide molecules
When were beer jugs found earliest
10000 BC
Mead
First intentionally produced drink– fermented honey
Code of Hammrabi 1790
Specified standards of quality of alcohol, hours of wine shops, shop employees and penalties for disobedience
Cult of Dioysus
Devoted to heavy drinking because it brought them closer to the gods
When was drinking a part of greek culture
2000 BC
Seneca
Defined excessive drinking characteristics including loss of control
Ulpan
Suggested the addictive nature of alcohol and though it was a disease
Distillation
Boiling a fermented beverage so that the steam has greater alcohol content– 700AD in Arabia
Highest % naturally fermented alcohol
14% before alcohol kills yeast and stops
Gin
Potatoes and flavoured with juniper berry
Gin Epidemic
1720– Period of excessive gin consumption in London
Who spoke out against alcohol in NA
Benjamin Rush- Signer of the declaration of independence
Benjamin Rush
Said alcohol was a disease and abstinence the only cure
– Inebriometer
American Society for Promotion of temperance
1826– at first was just about moderatipn but changed to the American Temperance Union in 1836 and promoted abstinence
Women’s Christian Temperance Union
1873– Carrie Nation
Prohibition in Canada
1918-1919
When was the volstead act rpealed
1933
% of Canadians who are current drinkers
80%
–20% drink problematically
% of deaths that are alcohol related
10%
AWOL
Alcohol without liquid
- Fine mist of alcohol is inhaled and absorbs very rapidly
Where is alcohol absorbed
20% in the stomach
80% in small intestine and colon
What enzyme break down alcohol in the stomach
Alcohol dehydrogenase
How much does food lower BAC peak
50%– delayed emptying into intestines allows for more enzyme breakdown
Carbonation
Speeds gastric emptying and absorption
Do lean people have a higher or lower BAC
Lower because they have more water to distribute the alcohol into
% of alcohol metabolized by alcohol dehydrogenase
15%– Women have 50% less in their bodies
What does the liver breakdown alcohol into
Alcohol dehydrogenase turns it into acetaldehyde
How is acetaldehyde broken down
By acetaldehyde dehydrogenase to acetic acid, CO2 and water
% of alcohol escaping through sweat and lungs
5% sweat
15% lungs
Standard drink
1 beer
150mL of wine
45 mL of spirits
—- all contain 13.5 g of alcohol
BAC curve
Amount of alcohol in blood as a function of time since ingestion– 0.05= 0.05%
Alcohol diffusion
Diffuses steadily across capillary walls including the blood brain barrier
Alcohol effects
Behavioural ataxia and motor coordination
Lowers Body temperature
increases vasodilation
Disinhibition Theory
Alcohol lowers inhibitions that normally keep aggressive behaviour in check
What NT is associated with impulsivity and violence
Low serotonin
When do hangovers occur
4-12 hours after cessation– acute withdrawals
Steatosis
Acute fatty liver syndrome occurs whenever alcohol is consumed
Alcohol Hepatitis
Caused by heavy drinking– low appetite, fever, enlargement of liver, tenderness
Ascites
Fluid accumulation in abdominal cavity
Cirrhosis
Degeneration of liver cells and thickening of surrounding tissue with a consequent decrease in hepatic blood flow
– Liver is unable to metabolize toxins
What % of alcoholics experience cirrhosis
10%
What % of people who drink get hepatitis or fatty liver
90%
Do women or men develop cirrhosis more rapidly?
Women
Anemia
Reduced oxygen carrying capacity of the blood
Alcohol dementia
Cognitive impairments caused by heavy drinking
– partly caused by B1 deficiency and malnutrition
Feminization
Reduction in testosterone and increase in estrogen causing breast enlargement, testicular atrophy
– Alcohol diverts testes functioning
What is the LD50 for humans
BAC of 0.45
Antidote for heroin overdose
Naloxone
GABA
Benzodiazepine and GABA receptors create a chloride ion channel that is receptive to hypnotics
– Alcohol keeps the channel open longer allowing more ions and harder to generate action potential
Effects of GABA
Sedative, muscle relaxant, behaviour impairments
– reinforcing effects due to increase in dopamine activity in the frontal cortex and nucleus accumbens
NMDA glutamate recpetors
Alcohol dampens neurotransmission– uprated glutamate receptors cause withdrawal symptoms, responding to a sudden absence of alcohol
Alcohol effect on acteylcholine
Inhibits release– involved with learning and memory
Blocking what receptors reduces alcohol consumption
Cannabinoid
Dispositional/ Metabolic tolerance
Capacity of liver to metabolize alcohol increases with repeated administration– reduced alcohol entering blood stream and less available to brain
Acute/Within Session Tolerance
Blood concentration follows a bell shape following administration
Mellanby Effect
Less of an effect on the descending curve
Chronic/ Functional Tolerance
Long lasting adaptive changes to CNS
- Causes a shift to the right in DRC
- Motor ataxia, hypothermia
Alcohol abuse
3 criteria
Alcohol dependence
3 criteria and display signs of withdrawal or tolerance
% of alcoholics with a comorbid psychiatric conditon
40%
Delirium Tremens
Alcohol withdrawal due to a rebound increase in glutamate excitation and decrease in GABA inhibition
How can withdrawal be treated
Benzodiazepines and barbiturates
% of people who need help for drinking
10%– but 85% of people never seek treatment
Antabusw
Alcohol is metabolized to acetaldehyde which is metabolized further and excreted in urine– aversion therapy caused by buildup of acetaldehyde
Naltrexone
Opiate antagonist that blocks receptors so there is no increase in dopamine when drinking
Ancamprosate
Composite of excitatory NT acting in the glutaminergic system – diminishes excitability of glutamate receptors to reduce intensity of withdrawal
Jellinek
Disease concept of alcoholism 1960
Gamma drinker
True alcoholic– Suffers loss of control, abstinence is the only treatment
– No such thing as a recovered alcoholic
Washingtonian Temperance Society 1840
Alcoholics are reclaimed by former users with love– abstinence
Emmanuel Movement
Worcester 1900s– Alcoholism is a result of physical, spiritual and mental causes
3 guidelines of the emmanuel movement
Members must be volunteers
Abstinence is the goal
Patient had to be drug free before acceptance
AA
Founded by Richard peabody, Dr.Bob and Bill W
Minnesota Model
28 day long inpatient program
4 benefits of the reduced drinking model as opposed to abstinence
Many people avoid treatment if the goal is abstinence
People who don’t drink are weird
Abstinence is often confused with cure
can set people up for failure
Mello and Mendelson
Consumption habits can be altered using rewards and punishments — monetary reward
What is the cause of loss of control
Physiological response due to expectancies of alcohol effect– telling people they are drinking alcohol leeds to more consumption
Mark and Lisa Sobell
Ground breaking research in controlled drinking
- Gamma alcoholics went to a bar where staff are therapists and were given shocks if they didnt control themselves
Freud
Alcoholism due to unconscious homosexual instincts
3 different mice strain
C57BL
DBA
BALB
C57BL mice
Less effected by alcohol and consume more
Alcoholic sweet tooth
Rats bred to prefer alcohol, also show a preference for sugar
Knockout mice
Knockout a gene in a mouse to see if it effects how the mice reacts to alcohol
Low number of what recpetor causes mice to drink less and be less effcedted
Fewer serotonin
Fewer Cannabinoid receptors reduces reinforcement
Heritability measure
2 (Difference between identical and fraternal twins)
Heritability for alcoholism
70%
Concordance for MZ and DZ twins
MZ– 60%
DZ– 25%
Type 1 Alcoholism
Equal consequence of genetics and environment
- occurs in males and females
- Onset after age 25
- Associated with comorbid psychiatric disorders
Type 2 Alcoholism
Largely inherited and primarily in males – Gamma alcoholic
- FH+
Age of onset before 25
Associated with Antisocial Personality disorder and impulsivity
FH+
Higher blood actaldehyde levels following ingestion
- Slower breakdown causes flushing reaction
Greater stress dampening
Lower MAO activity
Faster P300 recovery times
Stress Dampening
Alcohol reduces stress reaction
Monoamine Oxidase
Enzyme that catabolizes neurotransmitters
P300
Positive voltage change following presentation of a stimulus
- oddball effcet
Who commented on the dangers of fetal exposure to alcohol
Plato and Aristotle
Abel
Infant death rate 2.5x higher when mother drinks
– Causes feeble memory, inability to learn
Teratogenic Effects
2 standard deviations below birth weight
Withdrawal symptoms after birth
Hyperactivity and inhibition problems
When do CNS abnormalities occur
During the 1st trimester
At what consumption rate does the risk for FAS increase
6 standard drinks a day
– cognitive effects at as little as 2 drinks a day
