Alcohol

Question 1

Neuronal Level

Answer 1

• Alters synapse and conduction
• Nonspecific:
  
  • makes membrane more fluid
  • High doses: inhibit Na+/k movement >> action potential can’t be generated
• Specific
  
  • Binds to GABA receptors (acts like GABA) inhibitory NT
    
    • More Cl- into cell >> difficult to stimulate
  • Glutamate: excitatory NT
    
    • inhibits glutamate transmission by blocking glutamate receptors
  • Dopamine in NA >> rewarding effects

Question 2

Behavioral affects

Answer 2

Low doses

• Excitment
• talkative
• exhilaration

Moderate

• Slurred speech
• irritable behavior

High doses

• Blackouts
• inhibits cerebellum
• Uncoordinated movements (drunk driving)
  
  • Reaction time longer
  • Decline in peripheral stimuli
  • decline in ability to be awake
• Drowsiness
• Stupor

Question 3

Acute Physiological effects (6 + hangovers and other-drug interactions)

Answer 3

• Respiratory depression
• Loss of heat >> dilation of blood vessels
• Inhibits antidiuretic hormone >> more peeing
• Depression of sexual performance
• Cardiovascular effects
• Reduces REM phase >> poor sleep and nightmares
• Interactions w other drugs
  
  • Synergistic: cocaine + alcohol
  • Antagonistic: MAO inhibitors + alcohol
• Hangovers
  
  • dehydration
  • Antidiuresis: due to increase in urination, leads to headaches and swelling
  • stomach irritation
  • Lots of sugar makes worse

Question 4

Chronic Effects (overview)

Answer 4

• Cancer
• Heart disease
• Liver disease: fatty liver, alcoholic hepatitis and cirrhosis
• Immune system
• Anxiety
• depression
• Alcoholic dementia
• Wernicke-Korsakoff syndrome

Question 5

Chronic effects: Cancer

Answer 5

Cancer

• Mouth Tongue pharynx and anywhere that comes into contact w alcohol bc its an irritant
• Depression of the immune system >> tumor increases in size
• Combined with tobacco common >> higher incidence of oral cavity pharynx and larynx
  
  • In women 41% increase in breast cancer

Question 6

Chronic Effects: heart

Answer 6

• Inflammes and enlarges heart
• Fatty acid increase in blood
  
  • Reduces diameter of blood vessels in body
  • Deposits can come loose & travel to brain, clogging smaller vessels >> stroke

Question 7

Chronic Effects: Alcohol Dementia

Answer 7

Alcoholic Dementia

• reduction of mass of brain
• Reduction in Ach receptors
  
  • reduction in intelligence and problem-solving abilities
  • Learning and remembering problems
  • Short term memory decline

*

Question 8

Wernicke Korsakoff Syndrome

Answer 8

Wernicke-Korsakoff syndrome

• Phase 1: Wernicke encephalopathy
  
  • Deficiency in thiamine (Vit-B1) brain needs it to use glucose
  • Confusion
  • Weird eye movements
  • Ataxia: difficulties in movements and body coordination
  • 15% recovery
• Phase 2: Korsakoff psychosis >> amnesia
  
  • Make up elaborate stories to compensate gaps in memory
  • 60% recover, 20% partially recover, 20% don’t recover

Question 9

Liver Diseases

Answer 9

• Fatty Liver
  
  • Liver too busy breaking down alcohol, can’t break down food
  • leads to accumulation of fatty acids
• Alcoholic Hepatitis
  
  • Inflammation of the liver due to by-product of acetaldehyde
• Cirrhosis
  
  • Liver cells replaced by collagen (scar tissue)
    
    • Decreased blood flow
    • Cell death
    • Loss of function
  • Irreversible
  • Genetic predisposition & requires 10 years of daily drinking

Question 10

Fetal alcohol Syndrome

Answer 10

• Only preventable cause of mental retardation
• Distinguishable characteristics
  
  • Low birth weight
  • CNS abnormalities & mental retardation
  • Deformed face and skull
    
    • Far apart eyes
    • Small head
    • Drooping eyelids
    • No lip cleft
• Riskiest during 3rd week of pregnancy (most women don’t realize they are pregnant)
• Later in life
  
  • ADHD
  • Short term memory issues
  • worsened problem solving

Question 11

Alcohol Tolerance

Answer 11

• Behavioral tolerance
  
  • Four Loko effect–> constantly change flavors so you don’t develop tolerance
• Metabolic Tolerance
  
  • Increased alcohol dehydrogenase
  • Increase acetaldehyde dehydrogenase
• Cellular tolerance
  
  • decreased sensitivity of receptors to alcohol

Question 12

Withdrawal Symptoms

Answer 12

• Appear in 5-18%
• Peaks 24-36 hours

1. insomnia
2. Severe hangover
3. Tremors
   
   • Sweating
   • Mild Agitation
   • Anxiety
   • Nausea
   • Vomiting
   • increased HR and blood pressure
   • Seizures
4. Delirium tremens: peaks 3-4 days
   
   • Hallucination
   • Nightmares
   • Extreme disorientation and confusion
   • Sweating
   • Fever
   • Possible
     
     • Heart failure
     • Dehydration
     • Suicide

Question 13

Alcoholism a disease?

Answer 13

• Defined as one since 1950, still no proper medical treatment
• Strong genetic component in type 2 alcoholics (younger-onset, male)

Question 14

Biological treatments

Answer 14

• Disulfiram (Antibuse)
  
  • inhibits acetaldehyde dehydrogenase >> accumulation of acetaldehyde >> person feels sick
  • Effects can occur with mouthwash or cough mixture
  • does not reduce cravings so compliance is low
• Opioid antagonists >> Naltrexone >> addresses cravings
• GABA related >> Acamprosate
  
  • mostly just works with combination of support group attendance and abstinence
• Seratonin Inhibitor >> works for type 2 (genetic alcoholism)

Question 15

Treatments social

Answer 15

• AA
  
  • Success unknown bc it’s anonymous but assumed to work
  • 12 steps
  • Difficult if you’re not religious because has many spiritual elements
  • Important in maintaining community and consistently coming to meetings
• SMART
  
  • You have the power yourself to overcome alcoholism yourself
  • NHP (No Higher Power) sobriety
  • Professional advisor
  • No reference to God