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Year 2 Pharma > Alcohol > Flashcards

Alcohol Flashcards

1
Q

How would you work out the absolute amount of alcohol consumed?

A

%ABV x 0.78

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2
Q

How many units is considered binge drinking in the uk?

A

> 8 units in one sitting

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3
Q

How much of alcohol is absorbed from what different parts of the body?

A

20% from the stomach directly

80% from the intestine

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4
Q

What is the speed of onset of intoxication proportional to?

A

Gastric emptying

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5
Q

Why does eating a meal decreases the speed of onset of alcohol?

A

Postprandial, the stomach does not empty often as it needs to break down food thus alcohol is not absorbed very well

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6
Q

How is alcohol metabolised?

A

90% is metabolised, 10% breathed off. 85% of metabolism occurs in the liver, 15% occurs in the GIT.
Liver metabolism: alcohol -> adetaldehyde (toxic) via 75% alcohol dehydrogenase and 25% mixed function oxidase.

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7
Q

Which type of enzyme is most significantly upregulated in chronic alcoholics?

A

Mixed function oxidase

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8
Q

Why does a shot of alcohol affect you more than the same amount of alcohol in 4 seperate doses

A

Because a single high dose alcohol bolus will saturate the enzymatic system

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9
Q

Why are women more susceptible to alcohol?

A

Men have a greater volume of body water and women have more adipose tissue, so the water allows alcohol to be more widely distributed in men so at a lower concentration -> men have more ADH as well so more able to metabolise

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10
Q

What is disulfiram and what is it used for? How does it work?

A

It is an inhibitor of aldehyde dehydrogenase - effective in alcohol aversion therapy as build up of acetaldehyde makes you feel sick and not want to drink alcohol

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11
Q

What is the potency of alcohol? Why?

A

Low
Influences a lot of receptors due to its uncomplicated shape however doesn’t fit a lot of the receptors very well so not a lot of efficacy

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12
Q

What effect does alcohol have on the CNS (mainly)

A

Depressant effect mainly - dependent upon environment and personality of the individual

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13
Q

How does alcohol depress the CNS system?

A

Increasing inhibition - pre and post synaptic

Reducing excitation - reducing stimulation at NMDA receptors and reducing Ca2+ influx so less NT exocytosis

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14
Q

Why is it difficult to assess the acute CNS effects of alcohol?

A

CNS is functionally complex

Ethanol has low potency therefore low selectivity

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15
Q

How does alcohol have euphoric effects on the CNS

A

Alcohol binds to the u receptor to inhibit GABA release - less inhib GABA so less inhib on DA release by the VTA DA neurones into the NAcc

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16
Q

What parts of the brain does alcohol affect?

A
  • Corpus callosum – information from leftàright.
  • Hypothalamus – controls appetite, emotions, pain, temperature.
  • RAS – consciousness.
  • Hippocampus – memory.
  • Cerebellum – movement & coordination.
  • Basal ganglia – perception of time.
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17
Q

What are the acute effects of alcohol on the CVS?

A

Vasodilation and increased HR

18
Q

What are the acute effects of alcohol on the endocrine system?

A

Diuresis (polyuria)

19
Q

How does alcohol cause vasodilation?

A

Cutaneous vasodilation - flushing by decreased Ca2+ influx so less VSM contraction leading to increased prostaglandins (vasodilators)

20
Q

How does alcohol increase heart rate?

A

Alcohol diminishes the control of the brain on the arterial baroreceptors and so the heart recieves less inhibitory input
-> SNS becomes dominant and heart rate increases

21
Q

How does alcohol cause diuresis (polyuria)

A

ADH (alcohol dehydrogenase) supresses VP release and less VP release leads to less water reabsorption causing diuresis

22
Q

What are chronic effects of alcohol on the CNS?

A

Dementia
Ataxia
Wernicke-korsakoff’s syndrome

23
Q

What happens to the brain in dementia?

A

Cortical atrophy and decreased cerebral white matter

24
Q

What happens to the brain in ataxia?

A

Cerebellar cortex degeneration

25
Q

What happens to the brain in wernicke-korsakoff’s syndrome?

A

Wernicke’s encephalopathy - affects the 3rd ventricle and aqueduct REVERSIBLE
Korsakoff’s psychosis - affects the dorsomedial thalamus (impairs memory - they make memories up) IRREVERSIBLE

26
Q

What is Wernicke-korsakoff’s syndrome due to?

A

Due to thiamine deficiency (less food intake as calories from alcohol)

27
Q

What are the chronic effects on the liver due to alcohol due to?

A

NAD+:
NAD+ is needed for lots of functions, alcohol dominates the use of NAD+ and thus NAD+ is not used for the other functions leading to a build up of other dangerous toxic by-products

28
Q

What are examples of chronic effects of alcohol on the liver?

A

Fatty liver
Hepatitis
Cirrhosis

29
Q

What is fatty liver in alcohol toxicity due to?

A

Lack of NAD+ leading to TAGs deposited in the liver

30
Q

What is hepatitis in alcohol toxicity due to?

A

Mixed function oxidases upregulated in chronic alcoholics leading to free radicals that generate an inflammatory response
Cytokines are then released eg increased IL-6 and TNF alpha

31
Q

What is cirrhosis in alcohol toxicity due to?

A

Fibroblasts lay down fibrin supportive structures that reduce regenerative capacity of liver - decreased regeneration and active liver tissue, increased fibroblasts

32
Q

What are positive effects of alcohol on the CVS?

A
  • decreased mortality from coronary heart disease
  • increased HDLs
  • increased tPA levels -> decreased platelet aggregation levels
  • polyphenols (red wine) may reduce free radicals
33
Q

What are the chronic effects of alcohol to the GIT?

A

Damages gastric mucosa (in proportion to the dose)

  • can lead to stomach cancer from acetaldehyde build up
  • acetaldehyde is a carcinogenic
34
Q

What are the chronic effects of alcohol on the endocrine?

A

Increased ACTH secretion -> cushing’s like syndrome

Decreased testosterone -> gynecomastia

35
Q

What are examples of symptoms as the blood alcohol concentration reaches 0

A
  • nausea
  • headache
  • fatigue
  • restless and muscle tremours
  • polyuria, polydipsia
36
Q

Why do you get nausea in a hangover?

A

Irritant -> vagus -> vomiting centre of medulla

37
Q

Why do you get headaches in a hangover?

A

Vasodilation

38
Q

Why do you get fatigues in hangover?

A

Sleep deprivation ‘rebound’

39
Q

Why do you get restlessness and muscle tremors in a hangover?

A

‘rebound’ excitation

40
Q

What do you get polyuria and polydipsia in a hangover?

A

Decreased VP secretion

Year 2 Pharma (34 decks)

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