Ethanol Flashcards
_____+______ = ethanol + CO2
yeast + sugar = ethanol + CO2
> ____% alcohol concentration is achieved via distillation
25%
> 25% alcohol concentration is achieved via ________
distillation
physiological effects of alcohol occur with _____ quantities
gram
volume and %AbV of Regular Beer
12 oz, 5.0% AbV
volume and %AbV of White Wine
5 oz, 12.0% AbV
volume and %AbV of Red Wine
4 oz, 15.0% AbV
volume and %AbV of Liquor
1.5oz, 40.0% AbV
proof = ?
%AbV x 2
what are “standard drinks”
contain same amt of alcohol in grams
Regular Beer, Wine, and Liquor all contain 14 grams of alcohol
primary absorption of alcohol occurs in the ________
duodenum
BAC stands for
blood alcohol concentration
6 things that affect peak BAC
Volume/Percent Ethanol Rate of Drinking Food Consumption Gastric Emptying Gastric Metabolism (ADH) Hepatic First Pass Metabolism
what effect does food have on alcohol absorption
SLOWS absorption
especially carb/protein rich foods
what effect does HIGH alcohol concentration have on gastric emptying
SLOWS gastric motility
what effect does LOW alcohol concentration have on gastric emptying
ACCELERATES gastric motility
drugs that ENHANCE gastric emptying have what effect on alcohol absorption
INCREASE alcohol absorption
ex: antihistamines, phenothiazines, metoclopramide
Examples of drugs that enhance gastric emptying
antihistamines, phenothiazines, metoclopramide
what is the effect of carbonated beverages on alcohol absoprtion
INCREASE alcohol absorption (via increased gastric pressure)
what does “increased alcohol absorption” mean in terms of alcohol concentration
increased alcohol concentration
what hormone is being referred to when talking about gastric metabolism and what effect does it have
ADH in the stomach, decreases amount of alcohol that gets to duodenum
male or female: increased ADH in the stomach
Males
increased gastric metabolism–> decreased absorption
male or female: more subcutaneous fat
female
fat has poor solubility
male or female: greater blood volume/greater volume of water
male
dilutes ethanol in blood stream
percentage of water in males
55-65%
percentage of water in females
45-50%
BAC = _______ alcohol per unit ______
GRAMS of alcohol per unit VOLUME
g/100mL, g/dL, mg/mL, g%, %, g/L (Europe)
1g/dL = __% BAC
1% BAC
1% BAC = __g/dL
1g/dL
Ethanol is primarily metabolized in the liver by ____
ADH (alcohol dehydrogenase)
what 2 enzymes account for >90% of ethanol metabolism
ADH and ALDH (alcohol DH and aldehyde DH)
rate limiting step in alcohol metabolism
ADH
microsomal oxidizing system
Cytochrome p450s
cytochrome p450s are known as the
microsomal oxidizing system
what CYP accounts for ~10% of ethanol metabolism
CYP2E1
CYP2E1 accounts for __% of ethanol metabolism
10%
what drug is used for methanol and isopropyl poisoning
Fomepizole
inhibits ADH, can’t form toxic metbolites
Fomepizole is used for
methanol and isopropyl poisoning
MOA of Fomepizole
inhibits ADH, can’t form toxic metabolites (Formaldehyde)
what 2 drugs inhibit CYP2E1 (drug interxns)
Warfarin and Phenytoin
chronic ethanol use _______ CYP2E1 expression and raises the risk for ____ toxicity
induces, CCl4 toxicity
interactions with catalase and CYPs increase _____ toxicity
acetaminophen
limits glutathione regeneration
how does CYP2E1 enhance oxidative stress
uses NADPH; limits NADPH needed for glutathione regeneration
CYP2E1 uses _____ which limits the regeneration of _______
NADPH, glutathione
what drug blocks ALDH
Disulfiram
what drug causes an accumulation of acetaldehyde when ethanol is consumed (makes you feel yucky to help stop drinking)
Disulfiram
Disulfiram inhibits _____
ALDH
accumulation of ______ and ______ may produce metabolic disorders
acetyl-CoA and NADH
ethanol impairs function of NAD+ requiring enzymes –> decrease TCA cycle –> accumulation of acetyl-CoA
accumulation of acetyl-CoA supports ____ synthesis and ____ storage
fatty acid synthesis, triglyceride storgae
what leads to alcoholic liver disease
ketone bodies accrue, accumulation of fat, protein, water in liver
_______ NAD+/NADH ratio contributes to hypoglycemia
decreased
caloric density of ethanol
7 kcal/g
caloric density of protein, carbs, and fat
protein and carbs = 4 kcal/g
fat = 9 kcal/g
ethanol metabolism produces ______
calories
ethanol follows ______ order elimination at VERY LOW BAC (<0.01 - IRRELEVANT)
first order
ethanol follows ____ order elimination at any relevant BAC (>0.01)
zero order (constant elimination)
BAC decreases _____% per hour
0.017% per hour
elimination rate of ethanol
0.017% per hour
how to solve BAC Elimination questions
- convert BAC to a percent (1g/dL = 1% BAC)
- Divide %BAC by elimination rate (0.017%/hr) to find # of hours
- Add the time from step 2 to starting time to find when BAC = 0
effect of gender on elimination
NO EFFECT!!!!!
gender effects absorption, distribution, and metabolism–but NOT elimination
%BAC when mood elevation, muscle relaxation, and decreased vigilance
0.02-0.03%
%BAC when relaxation, warmth, slowed reaction, and decreased fine muscle coordination
0.05-0.06%
%BAC when impaired balance, speech, hearing, and gross muscle coordination
0.08-0.09%
%BAC when gross impairment of physical and mental control
0.10-0.15%
%BAC when severely intoxicated, very little control of mind or body
0.20-0.30%
%BAC when unconscious, deep coma, death from respiratory depression
0.40-0.50%
legal limit for driving
0.08
2 reasons why females would have a greater BAC
smaller water/mass ratio, decreased gastric metabolism in females (increased absorption)
ethanol can be detected in what 4 ways
breath, urine, blood, and hair
glutamate binds to the _____ receptor
NMDA
what binds to NMDA receptor
glutamate
“gas pedal”/excitatory neurotransmitter
glutamate
NMDA receptor permits the influx of ____ ions
Calcium
ethanol ______ calcium channel opening at the NMDA receptor
INHIBITS CHANNEL OPENING
“brake pedal”/inhibitory neurotransmitter
GABA
GABAa receptor permits the influx of ____ ions
Chloride
ethanol ______ chloride channel opening at the GABAa receptor
INCREASES chloride channel opening (frequency and duration)
Ethanol ______ glutamatergic activity and ______ GABAergic activity
DECREASES glutamatergic, INCREASES GABAergic
ethanols intoxicating effects move from the _____ part of the brain to the _____ part of the brain as the dose increases
rostral to caudal
front to back
alcohol induced blackout is also known as
anterograde amnesia
what is associated with BAC > 0.20 and/or rapid increase in BAC
blackout/anterograde amnesia
what 2 things are associated with an alcohol induced blackout
BAC > 0.20
rapid increase in BAC
the severity of intoxication at a given BAC is greater with rising than falling gas called the ______ effect
Mellanby effect
the Mellanby effect states that the intoxication at a given BAC is ________ when rising than falling
greater
alcohol associated dementia is known as
Wernicke-Korsakoff Syndrome
what vitamin deficiency is associated with Wernicke-Korsakoff syndrome
thiamine
those with ______ levels of dependency are more susceptible to greater withdrawal severity
higher dependency
there is a direct relationship between ______ and withdrawal severity
tolerance
does tolerance develop to all effects
NO
also develops at diff magnitudes and rates
repeated withdrawal episodes leads to
kindling
kindling is associated with an abrupt imbalance of ______ and ______ activity
glutamatergic and GABAergic
an abrupt imbalance of glutamaterigic and GABAergic activity
kindling
ethanol withdrawal can be _____
FATAL
progression of ethanol withdrawal is ______
variable
ethanol induced hangover is an ______ withdrawal syndrome mediated in part by _______ accumulation and _______
ACUTE withdrawal syndrome, ACETALDEHYDE accumulation, DEHYDRATION
severe alcohol withdrawal symptoms, can be fatal
delirium tremens
group of conditions that can occur in a person whose mother drank during pregnancy
Fetal Alcohol Spectrum Disorder (FASD)
assume ethanol interacts with
ALL MEDICATIONS
a persons _______ of alcohol use influences the effects of some medications
History
chronic alcohol use decreases effect of rifampin
some drug-alcohol interactions are ________
life threatening
alcohol + anti-coagulants
3 medications to treat Alcohol Use Disorder
Disulfiram, Naltrexone, Acamprosate
Disulfiram inhibits ______, which increases _____ concentrations after drinking. reinforces abstinence to avoid the adverse reaction
inhibits ALDH, increases acetaldehyde concentrations
which drug inhibits ALDH, which leads to acetaldehyde accumulation when drinking. which causes adverse effect that reinforce abstinence
Disulfiram
Naltrexone is a ______ receptor _______. decreases feelings of ______ and ______
opioid receptor antagonist, decreases reward and cravings
which drug is an opioid receptor antagonist, which causes a decreased feeling of reward and decreased cravings
Naltrexone
Acamprosate is a _______ receptor antagonist and an activator of ______ receptors. decreases _______ symptoms
NMDA receptor antagonist, activator of GABA
decreases withdrawal symptoms
which drug is an NMDA receptor antagonist and an activator for GABA receptors which decreases withdrawal symptoms
Acamprosate
binge drinking brings a persons BAC to ____g% or above
0.08
binge drinking for men is ____ drinks and women is ____ drinks in ___ hours
men: 5 drinks, women: 4 drinks, in 2 hours