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Pharmacology and Therapeutics 2 Y2 > Alcohol > Flashcards

Alcohol Flashcards

1
Q

Why is it easier to understand dose of alcohol

A

Because its legal

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2
Q

Safe level of alcohol consumption?

A

<14 units/week

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3
Q

Where can Alcohol can be absorbed from ? % of absorption in each place?

A

Usually oral

- Alcohol can be absorbed from the stomach (20%) and the intestines (intestines designed for absorption) (80%)

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4
Q

How does drinking on a full stomach influence your blood alcohol level?

A

Much more alcohol is absorbed in the small intestine- if you drink on a full stomach, gastric emptying is delayed, and alcohol is less effectively absorbed

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5
Q

What % of alcohol is metabolised and where’s the rest of it

A

90% is metabolised- 10% doesn’t change at all, it’s just excreted, some of which is via the lungs and is what the breath test measures

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6
Q

Where is alcohol metabolised? What % where?

A

85% liver

15% GIT (stomach):

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7
Q

What enzymes metabolises alcohol

A
  • Alcohol dehydrogenase (metabolises 75%) and mixed function oxidase (25%) convert alcohol into acetaldehyde (this is toxic)
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8
Q

What is the metabolite of alcohol

A

acetaldehyde

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9
Q

what order kinetics of metabolism is alcohol

A

Zero order

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10
Q

What does alcohol metabolism depend on

A

first pass hepatic metabolism and saturation of liver enzymes

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11
Q

What causes tolerance to alcohol

A

upregulation of mixed function oxidase enzymes

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12
Q

Difference between men and women re. alcohol dehydrogenase

A

Females have much less of this enzyme in their stomach compared to men

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13
Q

Where can you find alcohol dehydrogenase

A

Stomach and liver

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14
Q

Why can alcohol diffuse across lipid membranes

A

its tiny size, it can just squeeze through the gaps in the membrane.

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15
Q
  1. A man and a woman of similar height and weight share a bottle of wine. Explain why the blood alcohol levels in the woman are likely to be higher.
A

Because women metabolise it less effectively in stomach, they have 50% less alcohol dehydrogenase in the stomach wall than men so more alcohol enters the blood stream, and it is then less well diluted/distributed across body tissues (more concentrated so more potent effect)

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16
Q
  • Acetaldehyde is broken down by….
A

aldehyde dehydrogenase

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17
Q

Acetaldehyde is broken down into …

A

inert acetic acid (acetate)

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18
Q

What is disulfiram

A

aldehyde dehydrogenase inhibitor

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19
Q

An aldehyde dehydrogenase inhibitor?

A

Disulfiram

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20
Q

use of aldehyde dehydrogenase inhibitor

A

alcohol aversion therapy

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21
Q

Use of disulfiram

A

Alcohol aversion therapy

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22
Q

Potency of alcohol?

A

Low

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23
Q

Low potency of alcohol means what regarding drug targets

A

has a weak effect on a lot of targets (low potency)

24
Q

What makes the potency of alcohol low

A
  • Weak affinity and low efficacy
25
Q

Why are alcohol ACUTE EFFECTS DIFFICULT TO FIGURE OUT

A

CNS IS COMPLEX AND ETHANOL HAS LOW POTENCY + SELECTIVITY (because its so low in potency there is no specific target for alcohol)

26
Q

Effect of alcohol on GABA

A
  • Positive effect on GABA receptors:
    Directly effects the GABA receptor post-synaptically, causing increase in function
    Also evidence that it acts pre-synaptically to increase release of allopregnenolone which binds to GABA receptors to increase their effect
27
Q

Effect of alcohol on NMDA receptors

A
  • Decreases NMDA receptor activation- NMDA receptor = excitatory
28
Q

Effect of alcohol on Ca channels

A
  • Decreases Ca2+ channel opening and impacts neurotransmitter release in general
29
Q

Euphoric effect of alcohol? Similar to what drug? What dose is needed

A
  • At high dose can behave like heroine and morphine

- Binds to opioid receptor and switches off GABA inhibitory signal, increasing firing rate of dopaminergic neurones

30
Q

Effect of alcohol on corpus callosum

A

Alcohol interferes with coordination of the sides of the brain

31
Q

Effect of alcohol on HYPOTHALAMUS

A

Effects appetite, emotions etc.

32
Q

Effect of alcohol on RETICULAR ACTIVATING SYSTEM

A

Alcohol impairs consciousness

33
Q

Effect of alcohol on HIPPOCAMPUS

A

Alcohol impairs memory

34
Q

Effect of alcohol on CEREBELLUM

A

Alcohol impairs coordination

35
Q

Effect of alcohol on BASAL GANGLIA

A

Alcohol impairs time perception

36
Q

Effect of alcohol on arterioles

A

Red face caused by increased acetaldehyde- interferes with smooth muscle function in the arterioles (vasodilation):

  • Impaired calcium entry
  • Increased prostaglandin release
37
Q

Effect of alcohol on heart

A

Tachycardia, Due to depressant effect on baroreceptors- stops them from enhancing parasympathetic fucntion and inhibiting sympathetic function

38
Q

Effect of alcohol on kidney

A

Diuresis Acetaldehyde inhibits production of ADH (vasopressin)- less aquaporins inserted into collecting duct- lose more fluid (polyuria)

39
Q

How does alcohol cause dementia

A

Alcohol causes cortical atrophy and decreased volume of cerebral white matter, confusion (encephalopathy) and oculomotor symptoms

40
Q

How does alcohol cause ataxia

A

Cerebellar cortex degeneration - gait

41
Q

How does alcohol cause WERNICKE-KORSAKOFF SYNDROME

A

Due to thiamine deficiency- alcoholics have a very poor diet and carbohydrates are needed to get thiamine- without it you get acidosis, excessive glutamate production etc.- neurones don’t work

42
Q

2 parts of WERNICKE-KORSAKOFF SYNDROME?

A
  • WERNICKE’S ENCEPHALOPATHY

and

  • KORSAKOFF’S PSYCHOSIS
43
Q

Describe - WERNICKE’S ENCEPHALOPATHY

A

This part is reversible
3rd ventricle and aqueduct damaged
Ataxia, eye problems, confusion

44
Q

Describe - - KORSAKOFF’S PSYCHOSIS

A

This is irreversible
Dorsomedial thalamus damaged
Memory problems from hippocampus damage
Confabulation, eventually death

45
Q

What do you use to metabolise alcohol to acetaldehyde

A

NAD+

46
Q

First things you see when someones been binge drinking? Why

A

After binging alcohol you lose ability to metabolise fats and lipids, a fatty liver containing lots of triacylglycerol is one of the first things you see when binge drinking alcohol.
this is because NAD+ is needed for glycolysis, making Acetyl-CoA, Krebs cycle etc.

47
Q

How does binge drinking cause liver acidosis/ketosis

A

Lack of NAD+ causes pyruvate to be converted to lactate and Acetyl-CoA to be converted to ketones

48
Q

Alcohol acute liver effect?

A

Fatty liver

49
Q

Alcohol chronic liver effect? (2) cause?

A

Liver inflammation and hepatitis from leaked free oxygen radicals

50
Q

Where do leaked free radicals come from

A

Mixed function oxidase system overuse

51
Q

Longer chronic effect of alcohol on liver? (2)

A

FIBROBLAST INFILTRATION & CIRRHOSIS

52
Q

When does liver damage become irreversible (2)

A

AFTER FIBROBLAST INFILTRATION & CIRRHOSIS

53
Q

Beneficial effects of low chronic use of alcohol (4)

A
  • Decreased mortality from coronary artery disease (men 2-4 units/day)
  • Increased HDLs
  • Increased tPA levels and decreased platelet aggregation
  • Are polyphenols protective (found in red wine)?
54
Q

ALCOHOL CHRONIC EFFECTS- GIT: (2)

A
  • Damage to gastric mucosa due to toxic acetaldehyde (can lead to ulceration etc.)
  • Carcinogenic effect
55
Q

ALCOHOL - CHRONIC EFFECTS- ENDOCRINE (2)

A
  • Increased ACTH secretion (and cortisol production)

- Decreased testosterone production

56
Q

Hangover headache caused by…

A

Vasodilation

57
Q

Hangover nausea caused by…

A

Irritant, vagus, vomiting centre

Pharmacology and Therapeutics 2 Y2 (24 decks)

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