Alcohol - Ley Flashcards
What percent of americans over 12 drink?
50%
what percent of people who drink have reported an alcohol related problem?
40%
repeatedly getting drunk at a young age increases the risk of developing….
an alcohol use disorder
what are the standard drink sizes?
12 oz beer
5 oz glass of wine
1.5 oz shot
In what groups was the risk of heart disease lowest?
drinking 6 days/week in men
1-2 days/week in women
t/f: alcohol reduces all cause mortality
true
what are some of the molecular benefits of alcohol?
Inhibits platelet aggregation
Antioxidants like flavonoids
Enhance insulin sensitivity, reduce fasting insulin, and may reduce stress
Decreased risk of peripheral artery disease
what are some of the risks of developing alochol abuse?
Genetics- 40-60%. Enhanced brain reward, decreased initial impairment, altered metabolism.
Sons of alcoholic fathers
Adolescents in alcoholic families- neuroanatomical differences, esp. amygdala
Alcohol dehydrogenase
Children with conduct problems- temperament or environment?
Often drink before age 15.
Higher level of inner distress, more drinking
Alcohol may induce the stress response
Moodiness, negativity, strained parent-child relationship
what is the single most important factor in deciding to drink?
parents
is alcoholism more common in men or women/
men
ADHD increases the likelihood of getting drunk how many fold?
14x
What are the protective factors against drinking?
parent-child connectedness
school connectedness
reduces the risk of SUD, sexuality, violence, improved emotional health
what percent of drinkers will progress to dependence?
10%
what percent of drinkers will continue to have problems in the next 5 years?
50-60%
what are the lab findings that suggest alcohol abuse?
GGT and CDT
AST/ALT
MCV
What are the physical findings that suggest alcohol abuse?
caput medusae
rhinophyma
GI distress (gastritis, esophagitis)
gout
what are the four questionairres for determining alocohol abuse?
CAGE
TWEAK
MAST
AUDIT
What are the liver complications drinking?
Hepatosteatosis
Alcoholic hepatitis
cirrhosis
Are men or women more at risk of developing liver complications?
women
How is tylenol cleared through the liver/
CYP 2E1
What are the CV complications of alcohol use?
alcoholic cardiomyopathy
2x as likely to have HTN
assc’d with sudden death and stroke
Elevated homocysteine from vit. def.
What is holiday heart?
congestive cardiomyopathy
A fib; converts within 24 hours
What are the most common types of cancer associated with alcohol abuse?
75% of esophageal cancer
50% of mouth, pharynx, larynx
what type of cancer is increased 130x if you drink and smoke at the same time?
esophageal
Increased estradiol in males who drink leads to…
OH GOD MOOBS
Chronic pancreatitis from alcoholism is caused by…
decreased capillary flow, edema, congestion, and diabetes
drinking within 30 mins of bed disrupts which half of sleep?
the later half
What are the cellular bases for increased risk of pulmonary infxn in alcoholism?
altered t cells
decreased NK fxn
neutrophil and macrophage action
B12 def from alcoholism leads to (blank) of the spinal cord
SUBACUTE COMBINED DEGENERATION
t/f: alcohol causes brain atrophy
true
What type of receptor is inhibited in the brain?
NMDA
NMDA is (inactive/overactive) in withdrawal
overactive
alcohol increases the action of which neurotransmitter?
GABA
GABA is underactive in what?
WD
alcohol causes the release of which monoamine, and lower levels of this monoamine are associated with higher drinking rates
5-HT
alcohol activates DA in what part of the brain?
ventral tegmentum
T/f: alcohol releases endocannabinoids
false; endogenous opioids
what part of the brain is especially vulnerable to alcohol/
PFC
Which hemisphere of the brain does alcohol affect more?
the right
t/f: alcohol crosses the placental barrier
true
What are the effects of alcohol on the fetus?
facial stigmata smaller brain volume behavioral difficulties learning problems attention growth
Children of alcoholics score lower on which metrics
family cohesion
independence
active recreation
intellectual/culturual orientation
How do children of alcoholics perceive others?
distant and judging
What is the key resilience factor in alcoholic families?
the nonalcoholic spouse
What types of abuse are increased in alcoholic families?
incest
t/f: divorce increases in alcoholic families
true
alcohol increases what types of crime?
homicide
sex offenders
traffic fatalities
What age group was particulary at risk when in the car where the BAC was elevated?
kids
what percent of people with a DUI will report an alcohol abuse disorder in their lifetime?
90%
alcohol abuse sig. increases what psych issue?
depression, anxiety, BPD
what fraction of alcohol abusers meet the criteria for a MDD?
1/3
what percent of adults with depression are alcoholic?
40%
what percent of alcoholics smoke?
80%
what is the effect of alcohol on sex?
decreased libido, testosterone, and sperm production
How do you conduct a brief intervention?
establish a drinking goal and follow up and assess motivation for change
what are the stages of change?
Precontemplation Contemplation Preparation Action Maintenance Relapse
what drug do you use to treat alcohol withdrawal?
benzo’s; decrease rebound symptoms
t/f: benzos can be used with liver disease
true
What is the half life of diazepam?
20-50 hours
what is the half life of librium?
5-30 hours
What is the half life of the metabolites of librium?
30-200 hours
CBT for alcohol abuse is particularly effective for which age group?
adolescents
which med is not recommedned for adolescents or in liver/kidney disease?
Naltrexone
666?
acamprosate
baclofen?
use to treat drinking?
Which anticonvulsant can be used to treat alcohol abuse?
depakote
which drug may block the rewarding effects of alcohol?
ondansetron
Which drug slows the return to heavy drinking?
buspirone
