Drugs of abuse 3 -Alcohol Flashcards
Where was alcohol first believed to be used
China – 9000 B.C.
What is the first known distilling technique for alcohol
Mongolian Still’ – 700 A.D
Summarise the epidemiology of alcohol consumption
Epidemiology – high alcohol consumption especially in Europe, Greenland and Russia.
How can we calculate the absolute amount of alcohol
% ABV x 0.78 = g alcohol/100ml (ABV = alcohol by volume)
How can we calculate the number of units in a given volume of alcohol
ABV% x volume (ml)/1000
1 unit = 10ml or 8g of absolute alcohol
What is the recommended weekly allowance of alcohol for men and women
Men & Women; 14 units/week LOW RISK
Define binge drinking
Binge drinking i.e. > 8 units in one sitting; 18% (> 30%) ↓
(16-24 yrs)
What is 0.01% of alcohol in the blood equal to
BLOOD LEVELS – 0.01% = 10mg/100ml blood
Describe the link between alcohol consumption and drink driving
Levels of alcohol in blood (for the same number of drinks) depends on your gender and body weight.
Legal driving limit is below 80 mg/100 ml- i.e 0.08% alcohol.
Subtract 0.01% for wach 40 minutes of drinking.
1 drink = 1.50z 80 proof spirit
12Oz 5% beer
5Oz 12% wine
Where is alcohol absorbed
20% - stomach
80% - small intestine
What is the speed of alcohol intoxication proportional to and why
Speed of onset of intoxication >proportional> to gastric emptying.
o Post-prandial, the stomach does not empty often as it needs to break down food thus alcohol is not absorbed very well – i.e. eating a meal decreases speed of onset.
On an empty stomach- fluid will just hit stomach lining and will leave the stomach stragiht away.
What percentage of the alcohol absorbed is metabolised
Metabolism – only 90% is metabolised, 10% breathed off
Where is alcohol metabolised
85% of metabolism occurs in the liver, 15% occurs in the GIT.
Describe the metabolism of alcohol in the liver
o Alcohol acetaldehyde (toxic) via:
75% - Alcohol dehydrogenase.
25% - Mixed function oxidase.
• MFO is most significantly upregulated in chronic alcoholics (only 25% in naïve drinkers).- this is the reason for alcohol tolerance.
Describe the metabolism of alcohol in the gut
The stomach contains alcohol dehydrogenase, which is responsible for 15% of alcohol metabolism
Women have 50% less alcohol dehydrogenase in their stomachs than men
Why would one large dose of alcohol give a larger plasma concentration than several smaller doses
The liver enzymes that are responsible for metabolising alcohol are saturable
o One high-dose alcohol bolus will saturate the enzymatic system and lead to a higher intoxication as opposed to the same absolute amount of alcohol over say 4 separate doses.