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Psychopharmacology Final > Alcohol - Textbook > Flashcards

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

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2
Q

in 3700 BC who prepared the first hearty beer and what was it called

A

Egyptians; hek

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3
Q

Where and when did wine possibly first come from

A

Babylonia; 1700 BC

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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

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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

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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

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7
Q

What did gin consumption become associated

A

lower class

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8
Q

What did the Continental Army and farmers/employers supply each soldier with each day

A

Rum and liquor

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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

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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

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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

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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

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13
Q

what was the alcohol content of medicinal tonics that became popular

A

75%

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14
Q

What was realized regarding the amendment in 1933

A

It was a failure

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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

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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

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17
Q

What is the outcome of drinking methyl alcohol

A

blindness, coma, death

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18
Q

Why cant methyl alcohol be consumed?

A

Because the liver metabolites of methyl alcohol include formic acid and formaldehyde

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19
Q

How is ethyl alcohol formed?

A

fermentation

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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)

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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

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22
Q

What percentage does the yeast die at?

A

15%

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23
Q

How do you develop higher alcohol concentrations that 15%?

A

distilling

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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

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25
Q

What is the typical alcohol concentration of distilled beverages?

A

40 - 50%

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26
Q

How do you make sherry with such a high alcohol percentage?

A

adding additionally alcohol

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27
Q

Where does calling alcohol concentration “proof” originate from ?

A

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

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28
Q

What does the “proof” number now correspond to ?

A

to twice the percent of alcohol concentration

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29
Q

Is alcohol high in lipid solubility

A

No

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30
Q

Where is alcohol absorbed

A

Gastrointestinal tract

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31
Q

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

A

absorption, distribution and clearance

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32
Q

What are behavioral effects described on the basis of

A

blood alcohol concentration

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33
Q

What blood alcohol concentration does it take to produce measurable behavioral effects?

A

.04%

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34
Q

What are/ percentage of the GI tract is used in absorption of alcohol

A

10% stomach and 90% small intestine

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35
Q

How do small alcohol molecules move across membrane barriers

A

passive diffusion from the high concentration

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36
Q

What can slow the absorption of alcohol

A

food in the stomach

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37
Q

How does having food in your stomach slow alcohol absorption?

A

it delays movement into the small intestine through the pyloric sphincter, a muscle that regulates the movement of material from stomach to intestine

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38
Q

What liquid can be effective in delaying absorption

A

milk

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39
Q

Do carbonated alcoholic beverages absorb more rapidly? Why or why not?

A

yes, carbonation speeds the movement of material from the stomach into the intestine

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40
Q

Is there gender differences in alcohol absorption? Why or why not?

A

Yes, certain enzymes in gastric fluid are about 60% more active in men than women

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41
Q

What effect does aspirin have related to gender differences?

A

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

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42
Q

What percentage of alcohol that reaches general circulation is metabolized by the liver

A

95%

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43
Q

How is alcohol excreted?

A

excreted as carbon dioxide and water in the urine

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44
Q

What happens to the remaining 5% of alcohol no circulated

A

excreted by the lungs and can be measured in one’s breath using a breathalyzer

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45
Q

How is alcohol metabolism different from most other drugs

A

the rate of oxidation is constant over time and does not occur more quickly when the drug is more concentrated in the blood

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46
Q

What is the average rate of metabolism per hour for alcohol

A

1 to 1.5 ounces of 80 proof alcohol per hour

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47
Q

How does intoxication occur

A

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

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48
Q

What is the most important first class enzyme for oxidizing alcohol and where is it

A

In the liver; and is called alcohol dehydrogenase

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49
Q

Where else is alcohol dehyrogenase found

A

also found in the stomach and it reduces the amount of available alcohol for absorption (first pass effect)

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50
Q

What is the first pass effect?

A

concentration of a drug is greatly reduced before it reaches the systemic circulation

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51
Q

What is the process of alcohol dehydrogenase

A

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
Q

What enzyme issue do 10% of asians have

A

genes that code only for an inactive form of the enzyme

53
Q

What happens to individuals genes that code only for an inactive form of acetyldehyde dehydrogenase

A

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
Q

What enzyme do 40% of asians have

A

have genes that code for both the active and inactive enzyme

55
Q

What happens to individuals who have genes that code for both the active and inactive enzyme

A

exhibit more intense response to alcohol but not necessarily an unpleasant one

56
Q

What is the second class of liver enzymes that convert alcohol to acetaldehyde family called

A

cytochrome P450; specifically CYP 2E1(

microsomal ethanol oxidizing system

57
Q

What does induction of liver enzymes mean

A

metabolic tolerance, when liver enzymes increase due to regular drug use/alcohol consumption

58
Q

Define acute tolerance

A

single exposure to alcohol (binge dirnking)

59
Q

What enzyme does chronic alcohol use increase?

A

P450 liver microsomal enzyme that metabolize the drug

60
Q

Define metabolic tolerance

A

rapid metabolism means that blood levels of the drug will be reduced producing diminishing effects

61
Q

Define pharmacodynamic tolerance

A

neurons adapt to continued presence of alcohol by making compensatory changes in cell function

62
Q

Define behavioral tolerance

A

potentially due to classical conditioning. Through trial and error to correct your actions to appear less intoxicated

63
Q

What are the 4 types of tolerance

A

Behavioral, pharmacodynamic, metabolic and acute

64
Q

What are possible explanations for hangover symptoms

A

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
Q

What are symptoms of abstinence syndrome from alcohol in heavy drinkers

A

tremors, intense anxiety, high blood pressure, rapid heart rate, excessive sweating, rapid breathing and nausea and vomiting

66
Q

What are signs of delerium tremens

A

irritability, headaches, agitation and confusion. Sometimes hallucinations, convulsions and delerium

67
Q

What is the relationship of the transition between moderate to heavy rinking according to thhe dose-response curve

A

the precise point where alcohol becomes damaging is not clear for a particular individual

68
Q

What are the effects of alcohol on memory (low dose and high dose)

A

low dose: memory dedicits are more based on expectation than on quanitity of alcohol
high dose: rapidly consumed may produce total amnesia (blackout)

69
Q

Under high stress conditions what effect does alcohol have on memory

A

may enhance performance by minimizing the damaging effects of anxiety

70
Q

What 3 aspects are aggression and other effects of alcohol dependent on

A

environment, mental state and expectations

71
Q

What does alcohol consumption do to REM sleep

A

suppresses REM

with chronic alcohol use it produces a rebound in REM that may interfere with normal sleep and produce nightmares

72
Q

What blood alcohol level is lethal in 50% of the population

A

.45%

73
Q

Why do most people not reach the lethal level

A

around .15% vomiting may occur and a blood alcohol level of .35% usually leads to unconsciousness

74
Q

Usual symptoms of alcohol poisoning include?

A

vomiting, slow and irregular breathing, cold clammy skin and pale bluish color

75
Q

What factors contribute to brain damage in long term heavy drinkers?

A

high levels of alcohol, elevated acetaldehyde, liver deficiency and inadequate nutrition

76
Q

What vitamin are drinkers seriously deficient in

A

Thiamine (B1) due to poor diet and failure of absorption

77
Q

What is a possible outcome of thamine deficiency

A

Wernicke-Korsakoff syndrome

78
Q

What occurs in Wernicke Korsakoff syndrome

A

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
Q

What can happen to the brain of alcoholics

A

enlarged ventricles attest to the extensive shrinking of brain tissue. Often exteensively effecting the frontal love

80
Q

What 5 areas outside the CNS does alcohol effect

A

1) Cardiovascular system
2) Renal-urinary system
3) Reproductive system
4) Gastrointestinal system
5) Liver

81
Q

What effect does drinking alcohol have when you are cold?

A

produces an even more serious drop in body temperature

82
Q

What is a positive effect moderate alcohol consumption may have

A

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
Q

What is the loss of fluids from alcohol due to

A

reduced secretion of antidiuretic hormone

84
Q

What effects can alcohol have on males reproductive organs

A

impotence, atrophy of testicles, reduced sperm production and shrinkage of the prostate and seminal vesicles

85
Q

What are 3 distinct disorders of the liver than an occur in alcoholics

A

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
Q

What are the 5 diagnosis signs of FAS

A
  • 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
Q

Though alcoholism is higher in men (20%) than women (5%-6%) what is found regarding organ damage etc

A

organ damage and related medical issues are more severe in women and develop more quickly. Women alcoholics have a higher death rate

88
Q

Why do women alcoholics have higher death rates

A

metabolic, genetic, physiolgical, neurobioloical and hormonal factors

89
Q

What effect does estrogen have in female alcoholics

A

speeds up liver damage because of its role in inflammatory processes and oral contraceptive use

90
Q

Regarding the effects on female alcoholics brain, how does it differ from male alcoholics

A

females have been shown to have greater reductions in white and great matter.

91
Q

Heavier drinking individuals who have a greater potential for addiction release ___ DA

A

less

92
Q

What are the nonspecific actions of alcohol

A

disturbs the relatiosnhip of protein in membrane, interacts with polar heads of phospholipids and alters lipid composition

93
Q

What are the specific actions of alcohol

A

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
Q

What is ethanols effect on G protein

A

ethanol stimulates the G protein that activates the cuclic adenosine monophosphate second messenger system

95
Q

What kinf od neurotransmitter is glutamate?

A

major excitatory

96
Q

What receptor does alcohol have the greatest effect on and what does it do

A

NMDA; a ligang gated channel that allows + charged ions to enter and cause local depolarization

97
Q

What are the 3 roles of NMDA receptors in alcohol effects

A

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
Q

What and how does alcohol effect glutamate transmitters

A

alcohol acutely inhibits it by reducing the effectiveness of glutamate at the NMDA receptor

99
Q

ALCOHOL IS A GLUTAMATE ANTAGONIST

A

ALCOHOL IS A GLUTAMATE ANTAGONIST

100
Q

What does acohol due the glutamate release in the brain

A

significantly reduces glutamate release into hippocampus = spacial memory deficits

101
Q

What relation do glutamate and alcohol have on blackouts

A

combo of temporary inhibition of NMDA receptors by alcohol and reduced glutamate release = amnesia/blackouts

102
Q

What do alcoholics have an increase of in their brain

A

the number of NMDA receptors in both the cerebral cortex and hippocampus

103
Q

What is GABA

A

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
Q

What is the dopamine pathway

A

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
Q

Why is the nucelus accumbens and its core important

A

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
Q

What id the role of the nucleus accumbens in drug use

A

supplying the primary reinforcing qualities that lead to repeated drug use and the motivation for the drug

107
Q

For a clinician what are the essential features of alcoholism

A

compulsive alcohol seeking and use despite damaging health and social consequences

108
Q

What was Jellinek (1960)’s distinction between chronic alcoholism and alcohol addiction

A

chronic alcoholism includes the physical and behaviroal consequences of long term alcohol use
alcohol addiction is craving and lacking control

109
Q

What was te disease model of addiction about

A

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
Q

What is the approximate statistic of alcohol issues in america

A

10% of Americans have a problem with alcohol use and 10.5 million are dependent on alcohol

111
Q

What is the major hurdle in treatment for alcoholics

A

denial

112
Q

Why is denial often so common with alcoholics due to aiding of families

A

families and friend often enable the alcoholic to function without getting treatment by making excuses for them etc

113
Q

What is the first step in treament for alcoholism

A

detoxification

114
Q

Why is detoxifiction important

A

because withdrawals are strong motivators and can be physiolgically dangerous

115
Q

Under medical care, what is given to detoxifying alcoholics

A

substitiuting with a benzo such as librium or valium as these drugs prevent alcohol withdrawal

116
Q

What is the second step in the treatment process of alcoholism and what does it provide

A

psychosocial rehabilitation which helps the alcoholic prevent relapse through abstinence or reduce the amount of alcohol consumed if relapse occurs

117
Q

What are the 3 basic types of psychosocial rehab

A

1) individual and group therapy
2) residential alcohol free treatment settings
3) self- help groups

118
Q

What is the Community Reinforcement WhatApproach

A

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
Q

What are the 2 basic strategies of the pharmacotherapeutic approach

A

1) making alcohol ingestion unpleasant

2) reducing its reinforcement qualities

120
Q

What does Disulfiram (antabuse) do

A

it inhibits ALDH, which is the enzyme that converts acetaldehyde to acetic acid in the normal metabolism of alcohol

121
Q

What happens if you drink alcohol while taking disulfiram (antabuse)

A

sharp rise in blood acetaldehyde accompanies by facial flushing, tachychardia, drop in blood pressure and nausea and vomiting

122
Q

What is Acamprosate drug

A

a partial antagonist at the glutamate NMDA receptor and significantly blocks the glutamate increase that occurs during alcohol withdrawal in rats.

123
Q

What does acamprosate do in relation to GABA

A

Similar structure to GABA, returns basal GABA levels to normal

124
Q

What is combined therapy

A

combining naltrexone, acamprosate, medical management and combined behaviroal interventions

125
Q

Statitstically what combination was the best outcome of cobined therapy

A

medical management with either naltrezone or combined behavioral interventions which led to 79% days of abstinence

126
Q

What is Campral and how does it work

A
  • 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

Psychopharmacology Final (6 decks)

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