Alcohol - Textbook Flashcards
1
Q
What year, how was mead brewed and what did it produce?
A
8000 BC; brewed from fermented honey ; first alcoholic beverage
2
Q
in 3700 BC who prepared the first hearty beer and what was it called
A
Egyptians; hek
3
Q
Where and when did wine possibly first come from
A
Babylonia; 1700 BC
4
Q
Why did members of the noble class exhibit signs of confusion and dementia
A
maybe due to lead poisoning caused by alcohol prepared with a flavor enhancer that had high lead content
5
Q
What is aqua vitae
A
means the water of life and represents the first distilled conversion of wine into Brandy during the Middle Ages in Italy
6
Q
Production of what alcohol by the Dutch is credited with the start of serious alcohol abuse in Europe and why?
A
Gin because it is far more potent than wine and its cheap
7
Q
What did gin consumption become associated
A
lower class
8
Q
What did the Continental Army and farmers/employers supply each soldier with each day
A
Rum and liquor
9
Q
When did American drinking levels begin to reduce and why
A
1830 when the temperance movement began a campaign to educate society about the dangers of long term alcohol consumption
10
Q
What arguments did anti alcohol campaigns trigger that are similarly used today for drug regulation
A
Alcohol is a source of evil and is directly responsible for broken families, poverty, social disorder and crime
11
Q
What did the law that was passed in 1917 prohibit and what was it officially called in 1920
A
Called the Eighteenth Amendment to the American Constitution; prohibited manufacture, sale, transportation and importation of liquor
12
Q
What 4 outcomes did this amendments period of prohibition unintentionally develop
A
1) increased illegal manufacturing that produced highly toxic forms of alcohol
2) increased consumption of distilled spirits since they were easier to hide and store
3) made drinking in illegal speakeasies a fad
4) increased activity of organized crime mobs
13
Q
what was the alcohol content of medicinal tonics that became popular
A
75%
14
Q
What was realized regarding the amendment in 1933
A
It was a failure
15
Q
what is the alcohol type that is found in beverages and how many hydrogen and hydrogen atoms does it have
A
ethyl alcohol; Two carbon atoms, a complement of hydrogens, plus the -OH
16
Q
what kind of alcohol is highly toxic if consumer and what is it typically used for
A
methyl alcohol; fuel, anti-freeze and industrial solvent
17
Q
What is the outcome of drinking methyl alcohol
A
blindness, coma, death
18
Q
Why cant methyl alcohol be consumed?
A
Because the liver metabolites of methyl alcohol include formic acid and formaldehyde
19
Q
How is ethyl alcohol formed?
A
fermentation
20
Q
What is fermentation
A
naturally occurs whenever microscopic yeast cells in the air fall on a product containing sugar. The material providing the sugar determines the type of alcohol (ex. wine = grapes)
21
Q
In fermentation, what does yeast do to the sugar molecules?
A
converts each sugar molecule into two molecules of alcohol and two molecules or carbon dioxide
22
Q
What percentage does the yeast die at?
A
15%
23
Q
How do you develop higher alcohol concentrations that 15%?
A
distilling
24
Q
How does distilling alcohol work?
A
heating the fermented mixture to the point where alcohol boils off in steam leaving water behind. The alcohol vapor passes through a series of cooling tubes and condenses to be collected as hard liquor
25
What is the typical alcohol concentration of distilled beverages?
40 - 50%
26
How do you make sherry with such a high alcohol percentage?
adding additionally alcohol
27
Where does calling alcohol concentration "proof" originate from ?
Old British army custom of testing an alcoholic product by pouring it on gun powder and attempting to light it. If it is 50%, gunpowder burns
28
What does the "proof" number now correspond to ?
to twice the percent of alcohol concentration
29
Is alcohol high in lipid solubility
No
30
Where is alcohol absorbed
Gastrointestinal tract
31
The rates of _____, ______ and ______ of alcohol are modified by many factors, all of which contribute to the highly variable blood levels that occurs after ingestion
absorption, distribution and clearance
32
What are behavioral effects described on the basis of
blood alcohol concentration
33
What blood alcohol concentration does it take to produce measurable behavioral effects?
.04%
34
What are/ percentage of the GI tract is used in absorption of alcohol
10% stomach and 90% small intestine
35
How do small alcohol molecules move across membrane barriers
passive diffusion from the high concentration
36
What can slow the absorption of alcohol
food in the stomach
37
How does having food in your stomach slow alcohol absorption?
it delays movement into the small intestine through the pyloric sphincter, a muscle that regulates the movement of material from stomach to intestine
38
What liquid can be effective in delaying absorption
milk
39
Do carbonated alcoholic beverages absorb more rapidly? Why or why not?
yes, carbonation speeds the movement of material from the stomach into the intestine
40
Is there gender differences in alcohol absorption? Why or why not?
Yes, certain enzymes in gastric fluid are about 60% more active in men than women
41
What effect does aspirin have related to gender differences?
aspirin inhibits gastric alcohol dehydrogenase and women have lower levels of this to begin with, therefore aspirin was eliminate any gastric metabolism of alcohol in women
42
What percentage of alcohol that reaches general circulation is metabolized by the liver
95%
43
How is alcohol excreted?
excreted as carbon dioxide and water in the urine
44
What happens to the remaining 5% of alcohol no circulated
excreted by the lungs and can be measured in one's breath using a breathalyzer
45
How is alcohol metabolism different from most other drugs
the rate of oxidation is constant over time and does not occur more quickly when the drug is more concentrated in the blood
46
What is the average rate of metabolism per hour for alcohol
1 to 1.5 ounces of 80 proof alcohol per hour
47
How does intoxication occur
because the metabolic rate is constant, if the rate of consumption is faster than the rate for metabolism, alcohol accumulates in the body and the individual becomes intoxicated
48
What is the most important first class enzyme for oxidizing alcohol and where is it
In the liver; and is called alcohol dehydrogenase
49
Where else is alcohol dehyrogenase found
also found in the stomach and it reduces the amount of available alcohol for absorption (first pass effect)
50
What is the first pass effect?
concentration of a drug is greatly reduced before it reaches the systemic circulation
51
What is the process of alcohol dehydrogenase
converts alcohol to acetaldeshyde, a potentially toxic intermediate, which normally is modified further by acetyldehyde dehydrogenase to form acetic acid. Further oxidation yields carbon dioxide, water and energy
52
What enzyme issue do 10% of asians have
genes that code only for an inactive form of the enzyme
53
What happens to individuals genes that code only for an inactive form of acetyldehyde dehydrogenase
drinking even small amounts of alcohol produces very high levels of acetaldehyde causing intense flushing, nausea and vomiting, tachychardia, headaches, sweating, dizziness and confusion.
54
What enzyme do 40% of asians have
have genes that code for both the active and inactive enzyme
55
What happens to individuals who have genes that code for both the active and inactive enzyme
exhibit more intense response to alcohol but not necessarily an unpleasant one
56
What is the second class of liver enzymes that convert alcohol to acetaldehyde family called
cytochrome P450; specifically CYP 2E1(
| microsomal ethanol oxidizing system
57
What does induction of liver enzymes mean
metabolic tolerance, when liver enzymes increase due to regular drug use/alcohol consumption
58
Define acute tolerance
single exposure to alcohol (binge dirnking)
59
What enzyme does chronic alcohol use increase?
P450 liver microsomal enzyme that metabolize the drug
60
Define metabolic tolerance
rapid metabolism means that blood levels of the drug will be reduced producing diminishing effects
61
Define pharmacodynamic tolerance
neurons adapt to continued presence of alcohol by making compensatory changes in cell function
62
Define behavioral tolerance
potentially due to classical conditioning. Through trial and error to correct your actions to appear less intoxicated
63
What are the 4 types of tolerance
Behavioral, pharmacodynamic, metabolic and acute
64
What are possible explanations for hangover symptoms
residual acetaldehyde in the body, alcohol induced gastric irritation, rebound drop in blood sugar, excess fluid loss and toxic effects from congeners(byd=products of fermentation and distillation)
65
What are symptoms of abstinence syndrome from alcohol in heavy drinkers
tremors, intense anxiety, high blood pressure, rapid heart rate, excessive sweating, rapid breathing and nausea and vomiting
66
What are signs of delerium tremens
irritability, headaches, agitation and confusion. Sometimes hallucinations, convulsions and delerium
67
What is the relationship of the transition between moderate to heavy rinking according to thhe dose-response curve
the precise point where alcohol becomes damaging is not clear for a particular individual
68
What are the effects of alcohol on memory (low dose and high dose)
low dose: memory dedicits are more based on expectation than on quanitity of alcohol
high dose: rapidly consumed may produce total amnesia (blackout)
69
Under high stress conditions what effect does alcohol have on memory
may enhance performance by minimizing the damaging effects of anxiety
70
What 3 aspects are aggression and other effects of alcohol dependent on
environment, mental state and expectations
71
What does alcohol consumption do to REM sleep
suppresses REM
| with chronic alcohol use it produces a rebound in REM that may interfere with normal sleep and produce nightmares
72
What blood alcohol level is lethal in 50% of the population
.45%
73
Why do most people not reach the lethal level
around .15% vomiting may occur and a blood alcohol level of .35% usually leads to unconsciousness
74
Usual symptoms of alcohol poisoning include?
vomiting, slow and irregular breathing, cold clammy skin and pale bluish color
75
What factors contribute to brain damage in long term heavy drinkers?
high levels of alcohol, elevated acetaldehyde, liver deficiency and inadequate nutrition
76
What vitamin are drinkers seriously deficient in
Thiamine (B1) due to poor diet and failure of absorption
77
What is a possible outcome of thamine deficiency
Wernicke-Korsakoff syndrome
78
What occurs in Wernicke Korsakoff syndrome
it is degenerative from confusion and disorientation to memory disorders.
It is characterized by bilateral cell loss in the medial thalamus and the mammillary bodies of the hypothalamus
79
What can happen to the brain of alcoholics
enlarged ventricles attest to the extensive shrinking of brain tissue. Often exteensively effecting the frontal love
80
What 5 areas outside the CNS does alcohol effect
1) Cardiovascular system
2) Renal-urinary system
3) Reproductive system
4) Gastrointestinal system
5) Liver
81
What effect does drinking alcohol have when you are cold?
produces an even more serious drop in body temperature
82
What is a positive effect moderate alcohol consumption may have
aids circulation
reduce the risk of heart disease as it increases the amount of good cholesterol in the blood while reducing the bad
reduces incidence of blood clots and stroke
83
What is the loss of fluids from alcohol due to
reduced secretion of antidiuretic hormone
84
What effects can alcohol have on males reproductive organs
impotence, atrophy of testicles, reduced sperm production and shrinkage of the prostate and seminal vesicles
85
What are 3 distinct disorders of the liver than an occur in alcoholics
fatty liver: accumulation of triglycerides inside liver cells (reversible)
alcohol hepatitis: accumulation of high levels of acetaldehyde
alcoholic cirrhosis: scar tissue accumulation from dead cells cutting off blood vessels that carry oxygen
86
What are the 5 diagnosis signs of FAS
- mental retardation (average IQ is often 68)
- low birthweight
- neurological problems
- Distinctive craniofacial malformations (small head, small wide set eyes, flattened vertical groove between the nose and upper lip
- Other physical abnormalities (cardiac defects)
87
Though alcoholism is higher in men (20%) than women (5%-6%) what is found regarding organ damage etc
organ damage and related medical issues are more severe in women and develop more quickly. Women alcoholics have a higher death rate
88
Why do women alcoholics have higher death rates
metabolic, genetic, physiolgical, neurobioloical and hormonal factors
89
What effect does estrogen have in female alcoholics
speeds up liver damage because of its role in inflammatory processes and oral contraceptive use
90
Regarding the effects on female alcoholics brain, how does it differ from male alcoholics
females have been shown to have greater reductions in white and great matter.
91
Heavier drinking individuals who have a greater potential for addiction release ___ DA
less
92
What are the nonspecific actions of alcohol
disturbs the relatiosnhip of protein in membrane, interacts with polar heads of phospholipids and alters lipid composition
93
What are the specific actions of alcohol
alcohol acts on specific sites on particular proteins, stimulates G prteoin which is linked to adenylyl cyclase, modifies gating mechanism channels and acts at neurotransmitter binding sits
94
What is ethanols effect on G protein
ethanol stimulates the G protein that activates the cuclic adenosine monophosphate second messenger system
95
What kinf od neurotransmitter is glutamate?
major excitatory
96
What receptor does alcohol have the greatest effect on and what does it do
NMDA; a ligang gated channel that allows + charged ions to enter and cause local depolarization
97
What are the 3 roles of NMDA receptors in alcohol effects
1) memory loss associated with intoxication
2) rebound hyperexcitability associated with the abstinence syndrome after long term use
3) NMDA mediated excitotoxicity associated with alcoholic brain damage
98
What and how does alcohol effect glutamate transmitters
alcohol acutely inhibits it by reducing the effectiveness of glutamate at the NMDA receptor
99
ALCOHOL IS A GLUTAMATE ANTAGONIST
ALCOHOL IS A GLUTAMATE ANTAGONIST
100
What does acohol due the glutamate release in the brain
significantly reduces glutamate release into hippocampus = spacial memory deficits
101
What relation do glutamate and alcohol have on blackouts
combo of temporary inhibition of NMDA receptors by alcohol and reduced glutamate release = amnesia/blackouts
102
What do alcoholics have an increase of in their brain
the number of NMDA receptors in both the cerebral cortex and hippocampus
103
What is GABA
major inhibitory amino acid neurotransmitter. It binds to the GABA a receptor and opens the chloride channel allowing chloride to enter the cell to hyperpolarize the membrane
104
What is the dopamine pathway
begins in the ventral tegmental area of the midbrain and courses rotrally to innervate various limbic structures including the nucleus accumbens and centtral nucleus of the aygdala
105
Why is the nucelus accumbens and its core important
it is part of the amygdala network of structres which integrates emotion with hormone responses and sympathetic nervous activity
its core is associated with the striatum which modulates movement
106
What id the role of the nucleus accumbens in drug use
supplying the primary reinforcing qualities that lead to repeated drug use and the motivation for the drug
107
For a clinician what are the essential features of alcoholism
compulsive alcohol seeking and use despite damaging health and social consequences
108
What was Jellinek (1960)'s distinction between chronic alcoholism and alcohol addiction
chronic alcoholism includes the physical and behaviroal consequences of long term alcohol use
alcohol addiction is craving and lacking control
109
What was te disease model of addiction about
emphasizes lack of willpower and personal weakness and treated alcoholism as medically and nonjudgmentally. When the addiction forms the individual no longer has control
110
What is the approximate statistic of alcohol issues in america
10% of Americans have a problem with alcohol use and 10.5 million are dependent on alcohol
111
What is the major hurdle in treatment for alcoholics
denial
112
Why is denial often so common with alcoholics due to aiding of families
families and friend often enable the alcoholic to function without getting treatment by making excuses for them etc
113
What is the first step in treament for alcoholism
detoxification
114
Why is detoxifiction important
because withdrawals are strong motivators and can be physiolgically dangerous
115
Under medical care, what is given to detoxifying alcoholics
substitiuting with a benzo such as librium or valium as these drugs prevent alcohol withdrawal
116
What is the second step in the treatment process of alcoholism and what does it provide
psychosocial rehabilitation which helps the alcoholic prevent relapse through abstinence or reduce the amount of alcohol consumed if relapse occurs
117
What are the 3 basic types of psychosocial rehab
1) individual and group therapy
2) residential alcohol free treatment settings
3) self- help groups
118
What is the Community Reinforcement WhatApproach
top ranked treatment methods that assumes that environmental contingencies are powerful in encouraging drinking behaviour but they can be modified to become powerful reinforces of nondrinking as well
119
What are the 2 basic strategies of the pharmacotherapeutic approach
1) making alcohol ingestion unpleasant
| 2) reducing its reinforcement qualities
120
What does Disulfiram (antabuse) do
it inhibits ALDH, which is the enzyme that converts acetaldehyde to acetic acid in the normal metabolism of alcohol
121
What happens if you drink alcohol while taking disulfiram (antabuse)
sharp rise in blood acetaldehyde accompanies by facial flushing, tachychardia, drop in blood pressure and nausea and vomiting
122
What is Acamprosate drug
a partial antagonist at the glutamate NMDA receptor and significantly blocks the glutamate increase that occurs during alcohol withdrawal in rats.
123
What does acamprosate do in relation to GABA
Similar structure to GABA, returns basal GABA levels to normal
124
What is combined therapy
combining naltrexone, acamprosate, medical management and combined behaviroal interventions
125
Statitstically what combination was the best outcome of cobined therapy
medical management with either naltrezone or combined behavioral interventions which led to 79% days of abstinence
126
What is Campral and how does it work
- stabilize chemical balance in brain during/after withdrawal.
- enhances GABA receptors
- inhibits activity of NMDA receptors
- LD50 not available
- Half life = 20-33
- Dizziness, drowsiness etc
- Don’t give to people with kidney damage
