alcohol study guide

Question 1

pharmacokinetics

Answer 1

• readily mixes with water and is soluble in fat
• easily absorbed from GI tract, diffuses throughout the body, readily enters most tissues, including brain (BBB)

**time from last drink to maximal absorption in blood is ~60 mins

Question 2

absorption and distribution

Answer 2

• rate of absorption extremely variable, for this reason, behavioral effects are described based on blood alcohol concentration (BAC) rather than on the amount ingested
• it would take an adult about an hour to metabolize the amount of alcohol that is contained in a 1 oz. glass of whiskey, 3.5 oz. of wine, or 12 oz. beer
• in general, it takes BAC of .04% to produce measurable behavioral effects
• easily absorbed from the GI tract and diffuses throughout the body: 20% from stomach and 80% from upper intestines (move across membrane barriers by passive diffusion)

Question 3

gender differences

Answer 3

• one beer is much more concentrated in the average woman compared to a man because:
• on average, males have greater vascular capacity: the larger the individual, drug more diluted
• men are larger than women; have greater fluid volume
• gastric metabolism of alcohol ~50-60% more active in males than females
• females: higher concentrations of alcohol that will be more rapidly absorbed
• when drinking same weight-adjusted amounts of alcohol: women ~7% high BAC than male
• women with higher body fat than men concentrate alcohol in plasma, drink for drink, more than men, raising the apparent blood level

Question 4

alcohol dehydrogenase

Answer 4

found in stomach, reduces amount of available alcohol for absorption

Question 5

alcohol-related accidents

Question 6

binge drinking

Answer 6

• 5+ drinks on the same occasion on at least 1 day in the past 30 days (for men)
• 4+ drinks for women

Question 7

alcohol metabolism (pathways)/ CYP450

Question 8

role of area postrema

Answer 8

blood monitoring system

• alcohol is very toxic
• concentration between .12 - .16 induces vomiting - especially with rapid drinking
• AP activation makes it harder to get lethal dose - will vomit first

vomiting area basically

Question 9

acute tolerance

Answer 9

occurs with a single exposure to alcohol

Question 10

drug disposition tolerance

Answer 10

increased enzyme activity = more rapid metabolism = less drug

Question 11

pharmacodynamic tolerance

Answer 11

neuronal adaptation

Question 12

behavioral tolerance

Answer 12

learn to adapt behaviors when allowed to practice while under the influence

Question 13

pharmacodynamics: chronic effects

Question 14

pharmacodynamics: Alcohol-Glutamate

Question 15

pharmacodynamics: Alcohol-GABA

Question 16

pharmacodynamics: Alcohol-Dopamine

Question 17

Alcoholism

Question 18

co-morbidity

Question 19

alcohol pharmacotherapy

Question 20

benzodiazepines

Answer 20

• increase GABA activity
• ameliorate withdrawal symptoms; prevent seizures and DTs
• long-acting, prevent withdrawal symptoms (either maintained or slowly withdrawn) allowing person to function

Drawbacks:
sedation 
psychomotor deficits
additive interactions with alcohol
abuse and dependence liabilities

Question 21

anticonvulsants mood stabilizers

Question 22

campral/anticraving drugs

Question 23

disulfiram

Question 24

heavy use

Answer 24

five or more drinks on the same occasion on at least 5 different days in the past 30 days

Question 25

psychological effects

Answer 25

• feels relaxed and less anxious
• may feel somewhat sleepy
• relaxed state is demonstrated by reduced social inhibition more gregarious, talkative, and friendly or inappropriately outspoken
• self-perception and judgement somewhat impaired, more confident than reality proves true
• reduced judgement and induce overconfidence increased risk-taking and may make sexual encounters more likely

Question 26

CNS-related effects

Answer 26

low dose:

• deficits are based more on expectation than on quantity consumed
• under high-stress conditions, it enhances performance by minimizing anxiety

high dose:
- may cause amnesia for the events occurred during intoxication even though individual behaved quite normally

Question 27

blackout

Answer 27

common occurrence for alcoholics; occurs in 25% of social drinks

Question 28

alcohol poisoning

Answer 28

unconsciousness, vomiting, slow and irregular breathing and skin that is cold, clammy, and pale bluish in color

Question 29

when death occurs

Answer 29

due to depression of respiratory control center in the brain stem.
once respiratory mechanism is compromised the drinker can survive for 5 minutes but brain damage from oxygen deprivation occurs