Alcohol and Nicotine

Question 1

**Alcohol Genetic Components

Answer 1

• GABAA2 receptors
• Serotonin 1B Receptor
• Dopamine D2 Receptor
• Tryptophan Hydroxylase
• Neuropeptide Y
• ALDH2
• Serotonin Transporter

Question 2

Alcohol + Environmental Components

Answer 2

Religion
Urban residency
H/O sexual abuse
Single
Deceased parents

Question 3

Alcoholism Medical Complications

Answer 3

Alcoholic liver disease
Pancreatitis
Cardiomyopathy
Malnutrition and vitamin deficiency (thiamine)

Question 4

Alcoholism Social Components

Answer 4

Martial failure
Loss of job
Child and spouse abuse
Drunk driving/accidents

Question 5

Alcoholism Pharmacology

Answer 5

CNS depressant with properties of a sedative/hypnotic

• As dose levels rise, it will produce sedation, sleep unconsciousness, coma. Last is respiratory and CV depression and death
• Affects CNS neurotransmitters GABA and dopamine
• Binds GABA(A) receptor

Question 6

GABA(A) Receptor Binding leads to

Answer 6

Sedation, CNS depression

Narcotic effects and death due to direct opening of the receptor

Question 7

Alcohol Dose

Answer 7

14 grams of alcohol (12 fluid ounces beer, 5 ounce wine, 1.5 ounce whiskey
Lethal dose is > 500 mg/dL

Question 8

Alcohol PK

Answer 8

Rapid absorption from stomach and intestines (food in the stomach may delay gastric emptying)
Peak concentration is 30-90 minutes

Question 9

Alcohol dehydrogenase and aldehyde dehydrogenase

Answer 9

ADH converts alcohol to acetaldehyde
Acetaldehyde is converted to acetic acid by aldehyde dehydrogenase (ADLH)
Acetic acid is metabolized to CO2 and water

Question 10

**Alcohol follows what order of kinetics

Answer 10

ZERO
It doesn’t matter how much you drink, it will only be metabolized at a specific rate
It takes about 2 hours to eliminate one drink

Question 11

Alcohol Alternative Metabolism

Answer 11

2E1 in chronic alcoholism

Question 12

Alcohol at Lower Concentration Symptoms

Answer 12

Euphoria and disinhibition

Question 13

Alcohol at Moderate Concentration Symptoms

Answer 13

Control is impaired and dysphoria increases

Question 14

Alcohol at High Concentration Symptoms

Answer 14

Unconsciousness, coma and eath

Question 15

Define Wenicke encephalopathy

Answer 15

Thiamine deficiency

Question 16

Define Korsakow syndrom

Answer 16

Basal forebrain degenration

Question 17

Peripheral Effects of Alcoholism

Answer 17

Poly neuropathy
Haptatoxicity
Chronic gastritis
Malnutrition
Vitamin deficiencies
Pancreatitis
Dehydration
Facial features (gynecomastia, GI vasodilation)

Question 18

Natural –> Semi-synthetic
Morphine –>
Codeine –>
Thebaine –>

Answer 18

Heroin
Oxycodone and hydroxodone
Buprenorphine and naloxone

Question 19

Opioids + Reward Pathway

Answer 19

Project into the VTA and NA to release endogenous opioids (encephalin) which inhibit GABAergic interneurons

Question 20

Opioid Agonists do what?

Answer 20

Stimulate the mu receptor in the reward pathway which decreases the release of GABA

Question 21

Heroin PK

Answer 21

Crosses BBB and is converted to morphine in the brain

Metabolized by the liver and excreted in the urine and bile

Question 22

Opioid Tolerance Develops to:

Answer 22

Euphoria
Analgesia
Sedation

Question 23

Opioid Tolerance does NOT develop to:

Answer 23

Miosis
Constipation
Convulsions

Question 24

Opioid Withdrawals

Answer 24

8-10 hours after last dose

Primary (7-10 days) and secondary stages (24-30 weeks)

Question 25

Opioid Withdrawal Symptoms

Answer 25

``` Unhappy mood/yawning Aches/fever Pupillary dilation Goose bumps/sweating N/V/D ```

Question 26

**Marijuana Content

Answer 26

Delta9-THC

Question 27

Endocannabinoid System

Answer 27

CB1: brain CB2: Periphery (testes, spleen) and granular cells of the cerebellum Ligands (products of arachidonic acids): anandamide (AEA) and 2-arachidonoylglycerol (2-AG)

Question 28

Endocannabinoid System MOA

Answer 28

Endocannabinoid precursor are cleaved to active form and released after an increase in Ca Then they bind to presynaptic CB1 receptors which are coupled to inhibitory voltage sensitive Ca channels and activated K channels This all reduces membrane depolarization and exocytosis (inhibits the release of NT)

Question 29

Weed PK

Answer 29

Delta9-THC is a partial agonists of CB1 and CB2 | Metabolized by 2C9/3A4

Question 30

Weed Metabolites

Answer 30

11-hydroxy-delta9-THC (active) | 11-nor-carboxy-delta9-THC

Question 31

Weed Main Effects

Answer 31

Increased HR and food intake | Negative: anxiety, mild paranoia, hallucination

Question 32

Medical Marijuana Uses

Answer 32

Chemotherapy induce nausea Appetite stimulant in AIDS Pain Glaucoma

Question 33

High risk groups of individuals with pre-existing diseases for physical dependence are:

Answer 33

``` CV Respiratory Chronic bronchitis Schizophrenia Depression Other substance dependence ```

Question 34

Weed Withdrawal

Answer 34

Only in heavy users Symptoms: increased anxiety, restlessness, depression and irritability, disrupted sleep and decreased food intake Begins day 1 after stopping and last for 4-14 days depending on dependence