ch 33

Question 1

2 effects of alcohol on the brain

Answer 1

depression of CNS

activation of reward circuit

Question 2

Three target proteins that alcohol interacts with

Answer 2

GABA
Glutamate
5HT3

Question 3

rewarding effects of alcohol

Answer 3

result from binding with 5HT3 receptors in the brains reward circuit. when these receptors are activated, they promote release of dopamine, the major transmitter of the reward system. When alcohol binds with the receptors, it enhances serotonin-mediated release of dopamine and intensifies the reward process.

Question 4

what is the major reward neurotransmitter

Answer 4

dopamine

Question 5

characterized by confusion, nystagmus, abnormal ocular movements

Answer 5

Wernicke encephalopathy

Question 6

characterized by polyneuropathy, inability to convert short-term memory into long term memory and confabulation (unconscious filling of gaps in memory with fabricated facts and experiences)

Answer 6

Korsakoff psychosis

Question 7

which neuropsychiatric syndrome is not reversible

Answer 7

Korsakoff psychosis

Question 8

Neuropsychiatric syndromes are caused by what deficiency

Answer 8

thiamin from poor diet and alcohol induced suppression of thiamin absorption

Question 9

cerebral effect excessive alcohol

Answer 9

enlargement of cerebral ventricles in response to atrophy of the cerebrum itself. - may reverse in some individuals with cessation

Question 10

alcohol consumption to preserve cognitive function

Answer 10

low to moderate in older people may protect against the development of dementia.

red wine only - Resveratrol is responsible

Question 11

alcohol effect on sleep

Answer 11

disruptive

Question 12

Alcohol acute for cardiac

Answer 12

dilation of cutaneous blood vessels increasing blood flow to skin

Question 13

alcohol abuse and heart affects

Answer 13

direct damage to myocardium -> increased r/o heart failure

major cause of cardiomyopathy

dose dependent elevation of blood pressure

Question 14

moderate drinking women

Answer 14

1 drink a day or less

Question 15

moderate drinking men

Answer 15

2 or less a day

Question 16

moderate drinking is associated with

Answer 16

less ischemic stroke
CAD
MI
heart failure

Question 17

heavy drinking is defined as

Answer 17

5 or more a day

Question 18

heavy drinking and cardiac

Answer 18

increases risk of heart disease and stroke

Question 19

moderate drinking protects against heart disease by

Answer 19

raising levels of HDL

Question 20

what type of cholesterol protects against CAD

Answer 20

HDL

Question 21

what type of cholesterol promotes CAD

Answer 21

LDL

Question 22

Of all of the agents that can raise HDL, what is the most effective

Answer 22

alcohol

Question 23

How does alcohol offer heart protection

Answer 23

decreases platelet aggregation
decreases levels of fibrinogen
increases levels of tissue plasminogen
suppresses inflammatory component of atherosclerosis

Question 24

cardiac protection is determined primarily by

Answer 24

amount of alcohol consumed
and the pattern of drinking
NOT what you drink

Question 25

protection is greater for people who drink

Answer 25

moderately - 3-4 days a week as opposed to 1-2.

Question 26

cardioprotection is greater for those with an ____ lifestyle

Answer 26

unhealthy - up to 50% reduction in risk for those who eat fruits, vegetables, do not smoke - alcohol has little or no effect on incidence of coronary events

Question 27

alcohol metabolizes at what rate

Answer 27

constant rate no matter how you drink 15 mL per hour (0.5 oz) 1 drink per hour (practical)

Question 28

enzyme that metabolizes alcohol is

Answer 28

alcohol dehydrongenase

Question 29

alcohol ____ BP

Answer 29

raises low to moderate may help heavy drinking will cause HTN

Question 30

Alcohol overdose symptoms

Answer 30

vomiting coma hypotension resp depression vomiting plus unconsciousness can cause aspiration -> pulmonary obstruction and pneumonia alcohol induced hypotension results from a direct on the peripheral blood vessels and cannot be corrected with vasoconstrictors (epi) hypotension -> renal failure -> cardiovascular shock -> death do not give stimulants such as caffeine -> seizures

Question 31

a chronic, relapsing disorder characterized by impaired control over drinking, preoccupation with alcohol consumption, use of alcohol despite awareness of adverse consequences and distortions in thinking

Answer 31

alcohol use disorder

Question 32

the development of alcohol use disorder is influenced by what factors

Answer 32

genetic psychosocial environmental

Question 33

aging ____ body's tolerance for alcohol

Answer 33

lowers

Question 34

what drug does not have a cross dependence for alcohol

Answer 34

opioids

Question 35

benzodiazepines used most often for alcohol withdrawal

Answer 35

``` chlordiazepoxide clorazepate (Tranxene) oxazepam Lorazepam Diazepam ``` fixed schedule or PRN can be effective

Question 36

adjuncts to benzodiazepines for alcohol withdrawal

Answer 36

carbamazepine (antiepileptic) clonidine (Alpha adrenergic agonist) atenolol and propranolol (b blockers)

Question 37

drugs used to maintain alcohol abstinence

Answer 37

Naltrexone (Vivitrol) - blocks reward circuit Acamprosate - helps with anxiety and tension during abstinence Disulfiram (Antabuse) - makes deathly ill

Question 38

Naltrexone (Vivitrol) adverse effect

Answer 38

cannot be dependent! will precipitate withdrawal! nausea headache anxiety sedation

Question 39

Disulfiram (antabuse) side effects

Answer 39

``` nausea copious vomiting flushing palpitations headache sweating thirst chest pain weakness blurred vision hypotension -> shock-> death ``` ``` cardiac dysrhythmias resp depression cardiovascular collapse Congestive heart failure death ```

Question 40

Disulfiram effects can last from

Answer 40

30 min to several hours

Question 41

Cross tolerance to alcohol is associated with

Answer 41

general anesthetics and other CNS depressants but not opioids

Question 42

Abstinence syndrome occurs how long after last drink

Answer 42

12 - 72 hours

Question 43

What OTC med is contraindicated in chronic alcohol abusers

Answer 43

Tylenol - Liver