Chapter 5 - Ethyl Alcohol

Question 1

How do CNS depressants generally exert their effects?

Answer 1

By augmenting GABA and glutamate excitatory activity (NMDA).

Question 2

What is GHB?

Answer 2

A CNS depressant. General anesthetic. Common date-rape drug.

Question 3

Where is alcohol absorbed?

Answer 3

Rapidly in the gastrointestinal tract. Most in the upper intestine. 10-20% absorbed in stomach by enzymes called, Alcohol dehydrogenase, ADH.

Question 4

How/Where is alcohol metabolized and by what?

Answer 4

85% in the liver and the rest in the stomach. In both places, ADH breaks it down. Some alcohol is breathed out.

Question 5

What rate is Alcohol metabolized in relation to the concentration taken in?

Answer 5

It is metabolized at the same rate no matter how much alcohol there is.

Question 6

Who has a higher BAC: Someone with high body fat percentage or low body fat percentage?

Answer 6

High.

Question 7

At what BAC do blackout (loss of memory, but still functional) typically occur?

Answer 7

0.14%-0.3%

Question 8

What is the BAC for automatic legal intoxication?

Answer 8

.08%

Question 9

What are fatal BAC levels?

Answer 9

More than .4%

Question 10

By what percent is alcohol typically metabolized?

Answer 10

.015%

Question 11

What happens if you take a low dose of alcohol?

Answer 11

Dis-inhibition - Relief from anxiety. Loss of motor coordination. Small fall in BP.

Question 12

What happens if you take a moderate dose of alcohol?

Answer 12

Progressive respiratory depression, sleep, muscle relaxation.

Question 13

What happens if you take a high dose of alcohol?

Answer 13

Amnesia, profound drop in BP, unconsciousness, hypothermia, coma, and ultimately, death from respiratory depression and cardiac depression.

Question 14

What does alcohol do to blood vessels?

Answer 14

It dilates them, allowing for greater release of heat (Alcohol does not keep people warm).

Question 15

Does alcohol have diuretic effects? If yes, how does it exert this effect?

Answer 15

Yes, it inhibits vasopressin release. Vasopressin is a hormone that allows the body to retain water.

Question 16

What, in general, causes psychological dependence?

Answer 16

The dopaminergic reward pathway. Drug gives feeling of pleasure. Drug abstinence causes dysphoria and craving.

Question 17

How does alcohol have a metabolic tolerance?

Answer 17

The liver increases alcohol metabolizing enzymes.

Question 18

What are the severe symptoms of alcohol withdrawal?

Answer 18

Delirium tremors: severe form of alcohol withdrawal. Agitation, fever, convulsions. Delirium - severe, acute loss of mental functions.

Question 19

What are the 4(5) features of Alcoholism?

Answer 19

1. Craving. 2. Loss of control. 3. Physical dependence. 4. Tolerance. (5.) Denial.

Question 20

What are the adverse effects of alcoholism?

Answer 20

Liver damage (cirrhosis - liver is yellow), pancreatitis and chronic gastritis. Possible neuronal loss. Impaired immune system. Etc.

Question 21

What are the 5 ideal goals of alcoholism treatment?

Answer 21

1. Reverse alcohol effects (limit to supportive care- ex. providing fluids). 2. Limit withdrawal effects. 3. Treat co-existing conditions. 4. Limit neuronal injuries during detox. 5. Eliminate/reduce alcohol use.

Question 22

What are pharmacotherapuetic drugs that reduce alcohol relapse?

Answer 22

Disulfiram (Antabuse), Naltrexone (ReVia, Vivitrol), Acamprosate (Campral).

Question 23

What is Disulfiram (Antabuse) and how does it work?

Answer 23

An alcohol sensitizing drug. It inhibits aldehyde dehydrogenase (not ADH). End result: Build-up of Acetaldehyde. Controlled trials were disappointing.

Question 24

What is Naltrexone (ReVia, Vivitrol) and how does it work?

Answer 24

Reduces craving for alcohol. Opioid antagonist. Thought that reinforcing properties of alcohol involve opioid systems. Only has small effects.

Question 25

What is Acamprosate (Campral) and how does it work?

Answer 25

Thought to restore balance of GABA/Glutamate neurotransmission. It has GABA-agonistic effect and is inhibitory at NMDA receptors.