Exam 1: Alcohol Use Disorder

Question 1

Criteria for AUD DSM 5

Diagnostic and Statistical Manual of Mental Disorders,

Answer 1

Craving
Control
Consequences

Question 2

Craving

Answer 2

craving
tolerance
withdrawal

Question 3

Control

Answer 3

-drinking more or over longer periods than intended
-unsuccessful cutbacks/control
- spending long time obtaining or recovering from alcohol

Question 4

Consequences

Answer 4

Failure to fulfill major role obligations
Giving up social/occupational/recreational activities
Continued use despite knowledge of persistent physical/psychological problems
use in hazardous situations

Question 5

Acute alcohol effects

Answer 5

GABA enhanced, exaggerated inhibition (sedative, anxiolytic)
NMDA blocked, reduced stimulatory effect
Opioid peptide activated, reinforce reward (Mu)
Dopamine increase, addicting

Question 6

Chronic alcohol effects

Answer 6

Downregulation of GABA
Upregulation of NMDA
Reduced firing rate/DA release

Question 7

Chronic effects of alcohol in CNS

Answer 7

addiction
wernicke korsakoff*
cortical atrophy/dementia

caused by the lack of thiamine (vitamin B1)- vision, ataxia, memory imp

Question 8

Chronic effects of alcohol in hepatic/pancreatic

Answer 8

1. steatosis
2. alcoholic hepatitis
3. cirrhosis
4. pancreatitis

Question 9

Fetal alcohol syndrome complications

Answer 9

Small head
deformed hands, face, feet
Heart, liver, kidney defects
vision/hearing impairment
CNS, developmental delay, short attention span
hyperactivity, anxiety, social withdrawal

Question 10

Ethanol PK

Answer 10

Lipid soluble
Vd- TBW
Gender difference
Negligible CYP difference
Non-protein bound, small
crosses BBB easily
First order absorption
Zero order kinetics
Gastric emptying rate determines absorption

Question 11

Faster alcohol absorption

Answer 11

water, carbonation
gastric bypass
empty stomach/fast
increase GI emptying drugs
low BG

Question 12

Slower absorption

Answer 12

fatty meal/food (lipid/protein)
beer with high carbs
Drugs that slow gastric emptying (anticholinergics)
Smoking cigs
trauma, major blood loss, shock

Question 13

Negative consequences of alcohol abuse

Answer 13

hepatic/pancreatic/CNS complications
Hypertension
Cardiomyopathy
Peripheral polyneuropathy/myopathy
Demyelination
Intracranial hematoma
increased likelihood of cancer and infection

Question 14

Effect of alcohol (dose)

Answer 14

1. frontal cortex: cognition/reasoning
2. Cortex: memory/language
3. Cerebellim: balance
4. Diencephalon: memory formation
5. brainstem/midbrain: respiration and heart rate

Question 15

Meds for AUD

Answer 15

Naltrexone - if opioid free
Acamprosate - renal adjust
Disulfram = 12 hrs of no alcohol