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Psychopharmacology > Chapter 10: Alcohol > Flashcards

Chapter 10: Alcohol Flashcards

1
Q

The small non-ionized alcohol molecule is absorbed from the GI tract by _____—a process slowed by food in the stomach.

A

passive diffusion

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2
Q

Absorption in women is _____ because _____ gastric metabolism and smaller body size increase _____.

A

faster; reduced; the concentration

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3
Q

95% of alcohol is metabolized by _____ at a constant rate of 1 to 1.5 ounces per hour; 5% is excreted by _____.

A

the liver; the lungs

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4
Q

Alcohol dehydrogenase converts alcohol to _____. Further metabolism produces _____.

A

the toxic product acetaldehyde; carbon dioxide, water, and energy.

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5
Q

The _____ enzyme _____ metabolizes alcohol, as well as other drugs. Consuming them together may lead to dangerous blood levels because they compete for the limited amount of enzyme.

A

cytochrome P450; CYP 2E1

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6
Q

_____ occurs within a single drinking episode and may lead to dangerous driving when binge drinkers perceive that they are less intoxicated on the descending limb of the blood alcohol curve.

A

Acute tolerance

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7
Q

Chronic alcohol use increases _____ so metabolism is more rapid, causing metabolic tolerance to the effects of alcohol and cross-tolerance to other drugs metabolized by the same enzyme.

A

cytochrome P450 enzymes (enzyme induction)

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8
Q

Continued presence of alcohol produces compensatory changes in _____.

A

neuron function (pharmacodynamic tolerance).

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9
Q

Practicing an operant task under the influence of alcohol leads to improved _____.

A

performance (behavioral tolerance of the operant type)

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10
Q

Repeated alcohol administration in the same environment leads to the development of a compensatory response that occurs only in _____.

A

that environment (behavioral tolerance of the classical conditioning type).

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11
Q

Alcohol produces _____ and _____ with other sedative–hypnotic drugs (barbiturates and benzodiazepines).

A

physical dependence and cross-dependence

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12
Q

_____ after chronic heavy use of alcohol lasts for days and includes tremor, anxiety, high blood pressure and heart rate, sweating, rapid breathing, and nausea and vomiting.

A

Withdrawal

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13
Q

Severe withdrawal effects of alcohol called _____ include hallucinations, convulsions, disorientation, and intense anxiety.

A

delirium tremens

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14
Q

Behavioral effects of alcohol are directly related to _____, but at low doses, the _____ and _____ of effects are significant.

A

BAC; environment and expectations of effects

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15
Q

_____ on the CNS include relaxation, reduced anxiety, intoxication, impaired judgment, impaired memory, and sleep. Higher doses produce coma and death as the result of respiratory depression.

A

Dose-dependent effects

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16
Q

Heavy long-term alcohol use causes _____ leading to _____ causing _____: tremors, ataxia, and poor memory consolidation.

A

a vitamin B1 deficiency; cell death in the medial thalamus and mammillary bodies; Wernicke–Korsakoff syndrome

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17
Q

Multiple brain regions may be damaged by _____.

A

glutamate-induced excitotoxicity

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18
Q

Beneficial alcohol-induced cardiovascular effects include _____, _____ and _____.

A

vasodilation, elevation of good cholesterol, and lowering of bad cholesterol

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19
Q

Alcoholism increases the risk of _____, _____ and _____.

A

high blood pressure, stroke, and heart enlargement.

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20
Q

Alcohol has _____, it also increases sexual arousal while decreasing performance, increases appetite, and aids digestion by increasing gastric secretions.

A

a diuretic effect;

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21
Q

Liver damage associated with alcoholism includes _____, _____ and _____.

A

fatty liver, alcoholic hepatitis, and alcoholic cirrhosis

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22
Q

Prenatal exposure to alcohol may produce _____, which is characterized by mental retardation and other developmental delays, low birthweight, neurological problems, head and facial malformations, and other physical abnormalities.

A

FAS

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23
Q

Effects of prenatal exposure to alcohol are dependent on? Name 3 of 6

A 
blood alcohol level
pattern of alcohol use
fetal developmental stage at time of exposure
maternal nutrition
genetics
comorbid drug use
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24
Q

Studies of FAS in humans show significant behavioral and cognitive problems after high maternal drinking, particularly of the _____.

A

binge type

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25
Q

Ethanol has specific actions on multiple neurotransmitter systems but also has nonspecific actions that change _____.

A

the fluid nature of membrane phospholipids.

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26
Q

4 benefits of using animal models in alcohol research

A

(1) control for poor nutrition, liver damage, comorbid drug use, and psychiatric disorders associated with human alcoholic individuals
(2) permit the use of techniques inappropriate in humans; (3) allow genetic manipulations
(4) provide means for investigators to evaluate treatment strategies.

27
Q

Alcohol acutely _____ glutamate neurotransmission. How?

A

inhibits by reducing the effects of glutamate at the NMDA receptor and reducing glutamate release.

28
Q

Modulation of glutamate by alcohol has a role in ethanol-induced _____, rebound _____ during withdrawal, NMDA-mediated excitotoxicity causing brain damage, and the mental retardation associated with FAS.

A

memory impairment; hyperexcitability

29
Q

Chronic ethanol _____ NMDA receptors in humans and animal models and _____, providing an explanation for the hyperexcitability and seizures seen at abrupt withdrawal.

A

up-regulates; increases glutamate release

30
Q

Alcohol _____ GABA-induced chloride entry and hyperpolarization. How?

A

enhances by modulating GABAA receptors and stimulating GABA release.

31
Q

Extrasynaptic GABAA receptors in the shell region of the nucleus accumbens seem to mediate _____.

A

some of the reinforcing effects of alcohol

32
Q

Chronic ethanol leads to _____ of GABAA receptors, making the organism more sensitive to _____.

A

down-regulation; seizure-inducing agents

33
Q

Ethanol _____ dopaminergic cells in the VTA, causing the .

A

activates; release of DA in the NAcc to provide the positive reinforcement that leads to repeated drug taking

34
Q

In physically dependent rodents, withdrawal of alcohol _____ the firing rate of mesolimbic neurons, _____ DA release in the NAcc, and causes rebound depression of reinforcement mechanisms as shown by an elevation in the threshold for intracranial self-stimulation.

A

reduces; decreases

35
Q

Acute alcohol _____ opioid release and _____ gene expression of opioid peptides.

A

increases; increases

36
Q

Blocking opioid receptors with naloxone _____ alcohol self-administration. Mu opioid receptor knockout mice _____ to self-administer ethanol. High levels of μ-opioid receptors correlate with scores on _____.

A

reduces; fail; craving

37
Q

Alcohol-preferring rats release _____ opioids in response to ethanol and show _____ opioid peptide gene expression.

A

more; enhanced

38
Q

Ethanol modulates the function of many additional neurotransmitters to alter _____ and _____.

A

ionotropic and metabotropic signaling

39
Q

Chronic alcohol _____ gene expression and _____ levels of peptides.

A

reduces; lowers

40
Q

Alcoholism involves compulsive alcohol seeking and use despite damaging health and social consequences. _____ and _____ of drinking are as important as the quantity consumed.

A

Frequency and pattern

41
Q

Approximately _____% of Americans have an alcohol use problem. There are significant _____ differences in alcohol use, binge drinking, and heavy drinking.

A

10%; gender

42
Q

_____, _____ and _____ contribute to the vulnerability of a given individual to alcoholism.

A

Neurobiological, psychological, and sociocultural factors

43
Q

_____ reduces or increases alcohol consumption under different conditions. Alcohol _____ the activity of the brain stress systems and neuroendocrine stress systems that may lead to further alcohol use. _____ to stressors persists long after withdrawal.

A

Stress; increases; Sensitization

44
Q

_____ is a risk factor for adult alcohol abuse. _____ is a risk factor and is associated with a greater stress response and greater alcohol-induced suppression of the response.

A

Early life stress; Family history

45
Q

Cortisol sensitizes the DA mesolimbic pathway, which makes drug reinforcement _____.

A

more rewarding

46
Q

Disufiram _____ the enzyme that converts acetaldehyde to alcohol so that alcohol consumption causes _____.

A

inhibits; very unpleasant effects such as nausea and vomiting

47
Q

Genetics explains _____% of the variance of risk for alcohol dependence.

A

50% to 60%

48
Q

Genes for the _____ form of acetaldehyde dehydrogenase, the enzyme that converts the toxic metabolite acetaldehyde, predict _____ for alcoholism because alcohol has unpleasant effects.

A

inactive; low risk

49
Q

Gene polymorphisms for the 5-HT reuptake transporter, the 5-HT1B receptor, and the D4 receptor associated with anxiety or low sensitivity to alcohol _____

A

increase vulnerability to alcohol abuse.

50
Q

_____ and _____ determine attitudes about drinking and how much alcohol is available.

A

Social and cultural factors

51
Q

Detoxification under medical supervision is the first step in treatment and is followed by _____ to prevent withdrawal and gradual dose reduction.

A

benzodiazepine substitution

52
Q

Cultures that restrict use of alcohol have _____.

A

lower rates of alcoholism

53
Q

Naltrexone is an opioid receptor antagonist that _____ in some alcoholic individuals, perhaps by _____. Those with a family history of alcoholism and those with a μ-receptor polymorphism associated with reduced receptor expression respond better.

A

reduces consumption and craving; reducing the positive feeling caused by alcohol

54
Q

Targeting the opioid κ-receptor with an antagonist _____ self-administration only in dependent animals, suggesting that the κ-receptor may have a role in the anhedonic states associated with physical dependence.

A

reduced

55
Q

Blocking μ- and κ-receptors with a dual antagonist like nalmefene may _____.

A

improve abstinence rates in humans

56
Q

Acamprosate _____ the relapse rate. It _____ that occurs at withdrawal and returns basal GABA levels to _____ in the nucleus accumbens.

A

reduces; reduces the glutamate increase; normal

57
Q

Promising rodent studies targeting the stress response with CRF1 antagonists suggest that they may be effective in _____, as well as _____ behavior.

A

reducing withdrawal-induced increase in consumption; stress-induced relapse

58
Q

Animal studies suggest that blocking the NK1R for substance P _____ anxiety, alcohol consumption, and relapse behavior after withdrawal. In alcoholic patients, the antagonist reduced craving when patients were exposed to _____. The drug also normalized the brain response to _____.

A

reduces; stress- and alcohol-related cues; emotional stimuli

59
Q

Rapid tolerance formed during a single administration of a drug

A

acute tolerance

60
Q

Enzyme in the liver that metabolizes the acetaldehyde intermediate formed by alcohol oxidation into acetic acid.

A

acetaldehyde dehydrogenase (ALDH)

61
Q

Alcohol dehydrogenase (in GI) is _____ more active in _____

A

60% more active in men

62
Q

Aspirin inhibits gastric _____

Effects greater in _____

A

alcohol dehydrogenase; women

63
Q

Asian population: 10% have genes that code for an inactive form of _____.

A

ALDH

64
Q

Asian population: 40% have _____ and _____ form.

A

both active and inactive

Psychopharmacology (6 decks)

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