Exam 2 Flashcards
Parts of the Neuron
Cell Body & Nucleus Dendrites Axons Terminal Buttons or Axon Endings Glia Cell- “Schwann cells”
Cell Body & Nucleus
As in all cells, these help keep the cell alive & enable it to reproduce.
Dendrites
Receive messages from adjacent neurons.
Axons
Transmit messages through the neuron.
Terminal Buttons or Axon Endings
Send messages to adjacent neurons.
Glia Cell- “Schwann cells”
Wraps around axons, forming myelin sheath
Saltitory Conduction and Nodes of Ranvier
Enables transmission to skip from node to node through the neuron
Multiple Sclerosis
A disorder where the myelin deteriorates, broken down by the immune system for an unknown reason.
Ions
Are simply “charged particles”.
Salt (NaCl) + H2O= H2O + (Na+) + (Cl-)
The Cell Membrane
A phospholipid bilayer with proteins embedded. Hydrophobic heads (water soluble layer), hydrophilic tails (fat soluble layer)
Transmission Within A Neuron: Resting Potential
Inside of the neuron is slightly negative with respect to the outside.
About -70 millivolts
Transmission Within A Neuron: Graded Potentials
Stimulation produced change in the resting potential.
Graded means the change mirrors the amount of stimulation.
Two kinds: Hyperpolarization, Depolarization
Hyperpolarization
increased polarity
Depolarization
decreased polarity
Transmission Within A Neuron: Threshold
- Refers to the voltage level that needs to be reached for an action potential to occur.
- Threshold is about -60 to -65 millivolts.
Transmission Within A Neuron: Action Potential
- A large enough depolarization causes the inside of the cell to become positive with respect to the outside at the point of stimulation.
- Is contagious & results in the info being carried down the length of the cell.
- Is all-or-none, it either happens or it doesn’t happen.
Synaptic Transmission - Steps
Must be an action potential in presynaptic neuron.
Molecules involved in transmitter synthesis must be transported into cell.
Transmitter must be synthesized.
Transmitter must be stored (in vesicles).
Transmitter must be released into synapse.
Transmitter must interact with receptors in membrane of postsynaptic neuron.
Transmitter must be deactivated (by reuptake or breakdown by MAO).
EPSP, Excitatory Postsynaptic Potential
lead to depolarizations, more likely to see an action potential
IPSP, Inhibitory Postsynaptic Potential
lead to hyperpolarizations, less likely to see an action potential
Excitatory synapse
Round synaptic vesicles, postsynaptic thickening
Inhibitory synapse
Oval synaptic vesicles, no postsynaptic thickening
Spine synapse
Synapse has a “spine”, round synaptic vesicles, postsynaptic thickening
Spatial Summation
Two small EPSP’s that occur in close proximity add together to create an action potential.
Temporal Summation
When two EPSP’s occur in rapid succession from the same terminal button, the postsynaptic neuron doesn’t have time to recover completely from the first stimulation and an action potential results.
Chemical Criteria for Neurotransmitters
Should be found in the presynaptic cell.
Presynaptic cell should have the enzymes to make it.
A method for its deactivation should exist.
Its application to the postsynaptic membrane should work.
Following stimulation of the presynaptic cell, it should be present in the synapse.
Types of Neurotransmitters
Biogenic Amines: Catecholamines (norepinephrine, epinephrine and dopamine)
Indoleamines (Seratonin or 5-Hydroxytryptamine)
Others acetylcholine (Ach), GABA (Gamma-Aminobuytric acid), peptides, etc
Acetylcholine
Found in the neuromuscular junction and in areas of the brain involving memory
Occurs by breakdown (i.e., no reuptake).
Relevant enzyme is Acetylcholine Esterase (AChE).
Serotonin
Used in brain areas that regulate sleep, mood and appetite
Occurs primarily by reuptake. (SSRI)
MonoAmine Oxidase (MAO) does do some breakdown.
Catecholamines
Tyrosine->L-DOPA->dopamine->norepinephrine->epinephrine
Occurs primarily by reuptake.
Breakdown does occur though.
There are two relevant enzymes:
• MonoAmine Oxidase (MAO)
• Catechol-O-methyltransferase (COMT)
Mechanisms of Drug Action I: Neurotransmitter Synthesis
May increase or decrease synthesis of neurotransmitters.
Mechanisms of Drug Action I: Neurotransmitter Transport
May interfere with transport of neurotransmitter molecules to terminal buttons.
Mechanisms of Drug Action I: Neurotransmitter Storage
May interfere with storage of neurotransmitter in the synaptic vesicles.
Mechanisms of Drug Action I: Neurotransmitter Release
May cause terminal buttons to prematurely release neurotransmitter into the synapse.
Mechanisms of Drug Action I: Neurotransmitter Deactivation
May influence the breakdown of neurotransmitters by enzymes.
Mechanisms of Drug Action I: Neurotransmitter Reuptake
May block reuptake of neurotransmitters into the axon terminals.
Mechanisms of Drug Action I: Receptor Activation
May activate a receptor site by mimicking a neurotransmitter (i.e., an agonist).
Mechanisms of Drug Action I: Receptor Blocking
May cause a receptor to become inactive by blocking it (i.e., an antagonist).
Divisions of the NS
o Nervous system is divided into the CNS (Brain and Spinal cord) and the PNS (Somatic (voluntary) and Autonomic (involuntary) nervous system)
o Autonomic nervous system: divided into sympathetic and parasympathetic
Brain
Central core (hindbrain), Limbic System (midbrain), Cerebrum (forebrain)
Central core
Medulla: life preserving function (reflexes, breathing, BP)
Cerebellum: movement, motor coordination, posture, balance
Reticular formation: Arousal reactions, information screening (ability to selectively focus your attention)
Limbic System
Thalamus: major relay station for messages from all parts of the body, important in sensations of pain
Hypothalamus: Regulation of metabolism, temperature, emotions (homeostasis and behavior)
Hippocampus: important role in memory, uses Acetylcholine
Cerebrum
Corpus Callosum, Occipital lobe, Parietal lobe , Temporal lobe, Frontal lobe
Corpus callosum
communication between the brain’s right and left hemispheres
Occipital lobe
visual discrimination and some aspects of visual memory
Parietal lobe
somaesthetic and motor discriminations and functions
Temporal lobe
discrimination of sounds, verbal and speech behavior
Frontal lobe
learning, abstracting, reasoning, inhibiting
Brain Structure Review
Central Core (ARAS, Medulla, Cerebellum), Limbic System (Hypothalamus, Thalamus, Amygdala (aggression), Septum (submission), Hippocampus), Cerebrum (Occipital lobes, Parietal lobes, Temporal lobes, Frontal lobes)
Nootropics
Enhance mental performance (Smart drugs).
Ergogenics
Enhance physical performance (e.g., steroids & other hormones).
Hormones
Chemical substances secreted by glands. Are to the endocrine system what neurotransmitters are to the N.S.
Demographics
1 million Americans have used or are currently using.
90% of athletes in 1960 Olympics used. Estimates from 1993 suggest that 15% of NCAA & 50% of professionals use.
2% of college-aged men.
6.7% of male high school athletes.
1% of female high school athletes.
While athletes are not more likely to use most drugs of abuse, they are more likely to use these.
52,000 U.S. children & adolescents are using steroids.
In MA middle schools, 2.7% of athletes were using steroids (Begley et al., 1999).
Males are much more likely to use steroids than females (NIDA, 2004).
Some Hormones that Affect Behavior
Pituitary Pineal Adrenal Cortex Adrenal Medulla Pancreas Duodenum Gonads
Pituitary
the “master gland”. Interfaces with Hypothalamus
Pineal
melatonin is believed to play a role in circadian rhythms.
Adrenal Cortex
sex hormones & other steroids; corticosterone involved in stress.
Adrenal Medulla
adrenaline related to arousal & fight/flight response.
Pancreas
insulin affects hunger.
Duodenum
entrance to small intestine, CCK promotes satiety.
Gonads
sex hormones influence behavior & physical development.
Anabolic Steroids - Types
Oral
Parenteral
Oral
Clear the body in 2-14 days. Exs: • methandrostenolone - Dianabol • oxandrolone - Anavar • ethylestrenol - Maxibolin • stanozolol - Winstrol
Parenteral
Clear the body in 30 days. Less dangerous (especially for liver). Exs: • nandrolone deconoate (Deca-Durabolin) • testosterone cypionate (Depo-Testosterone)
Anabolic Steroids - 2 Primary Effects
Anabolic
- Increases muscle mass in one who is active & eating a lot (especially protein). Body building.
- Masculinizing
- Facial & body hair
- Broadening of the shoulders
- Deepening of the voice
- Adam’s apple
- Aggressive behavior
- Interest in sexual activities
Anabolic Steroids - Medical Uses
Hypogonadism (or testosterone deficiency).
Anemia (certain types) Stimulates red blood cell production.
Weight Gain - In underweight, elderly, wheel chair bound, or seriously ill.
Breast Cancer
Osteoporosis - Is a loss of bony tissue.
Arthritis - Reduces inflammation.
Anabolic Steroids - Abuse Issues
Became illegal in 1991.
-Extreme doses (10-100x therapeutic).
Stacking, Cycling, Plateauing, Pyramiding, Array
-Use of other drugs to help clear the steroid from the urine (or block it - ex. probenecid).
-Using oral & parenteral agents together.
Stacking
combining more than one steroid at a time
Cycling
or taking different steroids in sequence.
Plateauing
developing tolerance to a particular steroid.
Pyramiding
starting with low doses, moving to higher doses, then reducing doses at end of cycle.
Array
use of other drugs to avoid side effects. Exs. ing diuretics, anti-acne, anti-estrogens (to reduce breast growth in males).
Typical Patterns of Anabolic Steroid Use
Pattern of Use Dosing Wks
Light
Methandrostenolone (Dianabol) 15 mg, oral 6
Moderate
Methandrostenolone 20 mg, oral 10
Nandrolone decanoate (Deca-durabolin) 200 mg, im 10
Testosterone cypionate (Depo-Testosterone) 200 mg, im 10
Intense
Methandrostenolone 40 mg, oral 16
Oxandrolone (Anavar) 40 mg, oral 16
Nandrolone decanoate 600 mg, im 16
Boldenone undecylenate (Vebonol) 8 ml/wk, im 16
Anabolic Steroids - Side Effects 1
Hepatic - Liver dysfunction including tumors.
Cardiovascular - Increases BP & cholesterol.
Reproductive
M- testicular atrophy, less sperm, breast growth.
F- clitoris enlarges, abnormal menses, masculinization, breast shrinkage.
Immunologic - Increased susceptibility to infections. Less defense against abnormal tissue.
Psychological - Cyclic changes in libido. Mood changes- increased aggression (“roid rage”). Addiction.
Miscellaneous - Acne, hair loss/gain, muscle spasms, GI disturbances, water retention, stunted growth (adolescent males), unpleasant breath odor, swelling of feet & limbs.
Side Effects of Steroids in 10 Women Athletes
Effect # Reporting Reversible
Lower voice 10 no
Increased facial hair 9 no
Enlarged clitoris 8 no
Increased aggressiveness 8 yes
Increased appetite 8 unknown
Decreased body fat 8 unknown
Diminished/
stopped menstruation 7 yes
Increased sexual drive 6 yes
Increased acne 6 yes
Decreased breast size 5 unknown
Increased body hair 5 no
Increased loss of scalp hair 2 no
Other Hormones
Growth Hormone
Melatonin
Erythropoietin (EPO)
Thyroid Hormone
Synthetic Growth Hormone
- less easily detected agent
- has many of the effects of anabolic steroids.
- main side effect is acromegaly (increase in the size of hands, feet, & face).
- effect is irreversible & seen most often in the soft tissues/bones of the mandible, maxilla, forehead, & fingers.
- other side effects include enlargement of the visceral organs & cardiomyopathy
Melatonin
The hormone has a strong influence on a person’s circadian rhythms.
Produced by the light-sensitive pineal gland & is secreted only during darkness. Its secretion stops when the eyes are exposed to daylight or its artificial equivalent (which can occur even when the eyes are closed).
The trick in properly using melatonin to reset the body clock, a step called phase shifting, is to take the hormone at the right time and in the right amount to adjust the clock without causing sleepiness at the wrong time.
Other Ergogenic Drugs I
Zeranol, Carnitine, Clenbuterol, B-complex Vitamins, Deprenyl, Stimulants
Zeranol
Used to fatten cattle. Is a non-steroidal estrogen agonist derived from fungi.
Carnitine
An antioxidant that helps the body turn fat into energy. Anabolic.
Clenbuterol
Asthma (in Europe, not US). Anabolic.
B-complex Vitamins
Enhance body metabolism & increase energy.
Deprenyl
Parkinson’s disease; inhibitor of MAO. Amphetamine-like stimulant for endurance.
Other Ergogenic Drugs II
Caffeine, Ephedrine, & OTC Decongestants, Chromium Picolinate, Furosemide, Beta Blockers, Diuretics
Caffeine, Ephedrine, & OTC Decongestants
Treat asthma & congestion. Improve breathing, reduce fatigue & increase endurance.
Chromium Picolinate
Mineral. Weight control.
Furosemide
Mask steroid use & enable rapid weight loss.
Beta Blockers
Used to treat hypertension, cardiac arrhythmias, & social anxiety. Increases steadiness in shooting events & stimulates growth hormone.
Diuretics
To reduce water retention. Causes rapid weight loss by wrestlers, jockeys, & gymnasts as well as dilution of the urine to minimize detection in drug testing.
Other Ergogenic Drugs III
Blood Doping, Soda Doping or Buffer Boosting
Note: The word dope originates from the practice of Kaffir tribesmen in South Africa, who drank a mixture of alcohol & cola called dop, to gain increased energy & stamina. The Boer settlers in South Africa added an “e” at the end, giving the world the word that is frequently taken to mean illicit drugs in general.
Blood Doping
(Infusion with red blood cells from one’s own blood). No medical application. Increases O2 carrying capacity of the blood.
Soda Doping or Buffer Boosting
Liquid of bicarbonate soda drunk before an event; no medical application. Prevents lactic acid buildup in order to delay muscle fatigue.
Nootropics
Nimodipine, Ginko Bilboa, Vasopressin, Piracetam, Hydergine, Ephedra
Nimodipine
Ca+ channel blocker may help memory in the aged. Main use is treatment of ruptured blood vessel in the brain.
Ginko Bilboa
CNN
Increases blood flow to numerous regions of the body. Fights memory loss due to blocked blood vessels.
Vasopressin
First smart nasal spray & a pituitary hormone. Rumored to be a genuine hangover helper & brain enhancer.
Piracetam
Taken daily, it is supposedly a brain enhancer, improving flow of info between right & left hemispheres.
Hydergine
Has been shown to be useful in treating mental decline due to aging. Was originally developed to treat hypertension & is also used to stabilize oxygen levels in the brain. Another derivative of ergot discovered by Hoffman.
Ephedra
An ancient Chinese herb sometimes sold as Ma huang. Used in nasal decongestants. During 1994 & 95, the FDA received reports of 330 adverse reactions (heart attack, strokes, seizures, etc. including 12 deaths) to ephedrine containing products. At least a dozen states have restricted sales (partly because it can be used in the manufacture if CAT).
Nootropics - Nutrients
Dimethylaminoethanol (DMAE), Choline, L-phenylalanine, Pyridoxine or Vitamin B6
Dimethylaminoethanol (DMAE)
Short-term studies have shown an increase in vigilance and alertness with a positive influence on mood. Present in sardines & anchovies. A low-key stimulant.
Choline
precursor of ACh. To oversimplify, more choline=more ACh, & more ACh=better memory.
L-phenylalanine
a amino acid that produces E & NE.
Thiamine – or Vitamin B1 is an antioxidant that can reportedly protect nerve tissues from alcohol, drugs & other neuropollutants.
Pyridoxine or Vitamin B6
Is essential to optimal mental functioning. Believed to be particularly valuable for people who eat high-protein diets.
Homeostasis
Maintenance of internal stability; often biochemical in nature
Hormones
Chemical messengers released into the blood by glands
Nervous system
Relating to the brain, spinal cord, neurons and their associated elements
Endocrine system
Relating to hormones, their functions and sources
Neurons
Specialized nerve cells that take up the nervous system and release neurotransmitters
Glia
Supporting cells that are critical for protecting and providing sustenance for the neurons
Axons
An extension of the neuronal cell body along which electrochemical signals travel
Receptors
Special proteins in a membrane that are activated by natural substances or drugs to alter cell function
Synapse
Site of communication between a message-sending neuron and it’s message-receiving target cells
Synaptic cleft
A minute gap between the neuron and target cell, across which neurotransmitters transmitters travel
Dendrites
Short branches of neurons that receive transmitter signals
Opiate receptors
Receptors activated by opioid narcotic drugs such as heroin and morphine
Endorphins
Neurotransmitters that have narcotic-like effects
Cannabinoid system
Biological target of tetrahydrocannabinol in marijuana
Anandamide
A naturally occurring fatty acid neurotransmitter that selectively activates cannabinoid receptors
Angonistic
A type of substance that activates a receptor
Antagonistic
A type of substance that blocks a receptor
Muscarinic
A receptor type activated by ACh; usually inhibitory
Nicotinic
A receptor type activated by ACh; usually excitatory
Catecholamines
A class of biochemical compounds including the transmitters norepinephrine, epinephrine and dopamine
Sympathomimetic
Agents that mimic the effects of norepinephrine or epinephrine
Central Nervous System (CNS)
One of the major divisions of the nervous system, composed of the brain and spinal cord
Peripheral Nervous System (PNS)
Includes the neurons outside the CNS
Anticholinergic
Agents that antagonize the effects of acetylcholine
Nucleus accumbens
Part of the CNS limbus system and a critical brain region for reward systems
Frontal cortex
Cortical region essential for information processing and decision making
Autonomic Nervous System (ANS)
Controls the unconscious functions of the body
Steroids
Hormones related to the corticosteroids released from the adrenal cortex
Androgens
Male sex hormones
Anabolic steroids
Compounds chemically like the steroids that stimulate production of tissue mass
Barbiturates
Potent CNS depressants, usually not preferred because of their narrow margin of safety
Benzodiazepines
The most popular and safest CNS depressants in use today
Antihistamines
Drugs that often cause CNS depression, used to treat allergies and are often included in over the counter sleep aids
Sedatives
CNS depressants used to relieve anxiety, fear and apprehension
Anxiolytics
Drugs that relieve anxiety
Hypnotics
CNS depressants used to induce drowsiness and encourage sleep
Amnesiac
Causing the loss of memory
Anesthesia
A state characterized by the loss of sensation or consciousness
Frequently abused barbiturates
Amobarbital, pentobarbital, phenobarbital, secobarbital, tuinal
Frequently abused barbiturate-like drugs
Chloral hydrate, glutethimide, methyprylon, methaqualone, antihistamines
Social lubricant
Belief that drinking represses inhibitions, strengthens extroversion and leads to increased sociability
Methyl alcohol
Wood alcohol
Ethylene glycol
Alcohol used as antifreeze
Isopropyl alcohol
Rubbing alcohol, sometimes used as an antiseptic
Anesthetic
A drug that blocks sensitivity to pain
BAC
Blood alcohol concentration, concentration of alcohol found in the blood
Alcohol dehydrogenase
Principal enzyme that metabolizes ethanol
Behavioral tolerance
Compensation for motor impairment through behavioral pattern modification by chronic alcohol users
Polydrug use
The concurrent use of multiple drugs
Dishinhibition
Loss of conditioned reflexes due to depression of inhibitory centers of the brain
Diuretic
A drug or substance that increases the production of urine
Hepatotoxic effect
A situation in which liver cells increase the production of fat, resulting in an enlarged liver
Alcoholic hepatitis
The second stage of alcohol-induced liver disease in which chronic inflammation occurs; reversible if alcoholic consumption ceases
Cirrhosis
Scarring of the liver and formation of fibrous tissues; results from alcohol abuse; irreversible
Alcoholic cardiomyopathy
Congestive heart failure due to the replacement of heart muscle with fat and fiber
Wernicke-Korsakoff’s syndrome
Psychotic condition connected with heavy alcohol use and associated vitamin deficiencies
Fetal alcohol syndrome (FAS)
A condition affecting children born to alcohol-consuming mothers that is characterized by facial deformities, growth deficiency, and mental retardation
Binge use
A pattern of drinking five or more drinks for men and four or more drinks for women on a single occasion, such as the same time or within two hours of each other, on at least 1 day in the past 30 days; includes heavy use
Heavy use
Five or more drinks of the same occasion on each of 5 or more days in the past 30 days
Teetotalers
Individuals who drink no alcoholic beverages whatsoever, a term in common usage in decades past
Alcoholism
A state of physical and psychological addiction to ethanol, a psychoactive substance
Alcohol abuse
Uncontrollable drinking that leads to alcohol craving, loss of control, and physical dependence but with less prominent characteristics than found in alcoholism
Drunken comportment
Behavior exhibited while under the direct influence if alcohol; determined by the norms and expectations of a particular culture
Disinhibitor
A psychoactive chemical that depresses thought and judgement functions in the cerebral cortex, which has the effect of allowing relatively unrestrained behavior (as in alcohol inebriation)
Set and setting
Set refers to the individual’s expectation of what a drug will do to his or her personality; setting is the physical and social environments where the drug is consumed
Pseudointoxicated
Acting drunk even before alcohol has had a chance to cause its effects
Acquaintance and date rape
Unplanned and unwanted forced sexual attack from a friend or a date partner
Codependency
Behavior displayed by either addicted or no addicted family members (codependents) who identify with the alcohol addict and core up the excessive drinking behavior, allowing it to continue and letting it affect the codependent’s life
Enablers
Those close to the alcohol addict who deny or make excuses for enabling his or her excessive drinking
Relapsing syndrome
Returning to the use of alcohol after quitting
Acute alcohol withdrawal syndrome
Symptoms that occur when an individual who is addicted to alcohol does not maintain his or her usual blood alcohol level
Delirium tremens (DT’s)
The most severe, even life-threatening form of alcohol withdrawal, invoking hallucinations, delirium, and fever
Psychodrama
A family therapy system developed by Jacques Moreno in which significant interpersonal and intrapersonal issues are enacted in a focused setting using dramatic techniques
Role playing
A therapeutic technique in which group members play assigned parts to elicit emotional reactions
Genogram
A family therapy technique that records information about behavior and relationships on a rule of family tree to elucidate persistent patterns of dysfunctional behavior
PTSD
A psychiatric syndrome in which an individual who has been exposed to a traumatic event or situation experiences persistent psychological stress that may manifest itself in a wide range of symptoms, including re-experiencing the trauma, numbing of general responsiveness and hyperarousal
Volatile
Readily evaporated at low temperatures
euphorigenic
Having the ability to cause feelings of pleasure and well-being
Arrhythmia
A irregular heartbeat
Hypoxia
A state of oxygen deficiency
Who uses inhalants?
Of the grades sampled, 8th graders were the heaviest users.
These are among the most commonly used drugs by this age group.
List With Abuse Potential
Gasoline, glues & cements, paint thinners, lacquers & enamels, varnishes & varnish removers, cigarette or charcoal lighter fluid, fingernail polishes & polish remover, stain removers & other dry-cleaning products, upholstery protection spray products, windshield deicers, disinfectants, fire extinguishing volatile chemicals, typewriter correction fluid, permanent felt marker ink, aerosol hair sprays, vegetable frying pan lubricants, spray deodorants, spray paints, whipped cream propellants, freon.
Household Product and Possible Ingredients: Glues, plastic cements
Acetates, acetone, benzene, chloroform, hexane, toluene
Household Product and Possible Ingredients: Cleaning solutions
Tricholorethylene, petroleum products, carbon tetrachloride
Household Product and Possible Ingredients: Nail polish removers
Acetone
Household Product and Possible Ingredients: Lighter fluids
Butane, propane
Household Product and Possible Ingredients: Paints & paint thinners
Acetone, butylacetate, methanol, toluene
Household Product and Possible Ingredients: Petroleum products
Acetone, benzene, ether, gasoline, hexane, petroleum, tetraethyl lead, toluene
Household Product and Possible Ingredients: Typewriter correct fluid
Trichloroethylene
Household Product and Possible Ingredients: Hair sprays
Butane, propane
Toxicity: Acetone
Kidney damage.
Toxicity: Acetates
Possible liver damage.
Toxicity: Benzene
Repeated reports SSD, liver, kidney, & bone marrow damage common. Barred from public sale in many countries because of its toxicity.
Toxicity: Carbon Tetrachloride
Nausea, vomiting, weight loss, liver & kidney damage/failure. Anuria, jaundice, possible uremia & convulsions. SSD reported.
Toxicity: Gasoline
Fairly low toxicity. Occasional nerve damage & brain wave abnormalities.
Toxicity: Fluorocarbons
SSD common. Cardiac arrhythmia & cardiac failure. Massive respiratory failure reported.
Toxicity: Toluene
Fairly low toxicity. Possible liver & kidney damage.
Toxicity: Hexane
Damage to NS reported repeatedly.
Toxicity: n-Hexane
Severe damage to NS called polyneuropat.
Toxicity: Perchlorethylene
Uncertain. Possible liver & kidney damage.
Toxicity: Trichlorethane
SSD reported.
Alkyl Nitrites
Vasodilators with a psychoactive effect.
Amyl & Butyl are examples.
Alkyl nitrites are called “poppers” on the street.
A Chronology of Nitrite Inhalation Abuse
Date Example of inhalation
1867 First therapeutic use of amyl nitrite for angina pain (heart problems).
1960 Amyl nitrite prescription requirement eliminated by FDA.
1960s Recreational use of nitrites among young adults began & became widespread. High lasts a few minutes.
1969 Amyl nitrite prescription requirement reinstated.
1970 Street brands of butyl nitrite become available.
1974 “Popper” craze beginning.
1977 Nitrite inhalation predominant among homosexual men. Is said to enhance sex.
1979 >5 million people estimated to have used nitrites >1/week. 19 cases of Kaposi’s sarcoma found in retrospect.
1980 56 cases of Kaposi’s sarcoma reported.
1981 Increased suspicions of a link between nitrite use & Kaposi’s sarcoma.
1990s Nitrite inhalation abuse greatly reduced among nonhomosexual populations.
Nitrous Oxide (Laughing Gas)
Grand Exhibition - Discovered in 1776, parties were common in Europe & N. America in the 1800s.
Prescription for Scolding Wives?
More Modern Party
Currently used for sedating patients during dental procedures. It acts as a mild depressant when used in conjunction with oxygen in therapeutic amounts.
Binge Drinking
5 or more drinks on one occasion
Demographics - State & Local
WI is one of the biggest drinking states in the USA.
State Ranked 1st (AP - 6/22/88)
binging (3rd year).
binging & driving (2nd year).
chronic drinking (60+ drinks/month).
State Students Say They Use Alcohol (AP - 10/2/91)
63% of WI HS students use alcohol & 43% binged in previous month (only NY listed a higher figure - 64%).
WI Tops Nation in Binge Drinking: Report (AP - 8/1/97)
23% of adults are binge drinkers.
WI Act 100
New Law 7/1/2010: 2009 WI Act 100. Four main changes:
- 4th offense OWI is felony if it occurs within 5 years of an earlier offense.
- Ignition Interlocks Devices (IIDs) required for repeat offenders & 1st time offenders => 0.15 BAC.
- Increases 1st offense OWI to a misdemeanor if child (<16yrs) is in vehicle.
- Greater emphasis on treatment.
BAC Effects
# BAC Effects .02-.03 No overt effects, slight mood elevation.
.05-.06 Feeling of relaxation, warmth; slight decrease in RT & fine muscle coordination.
.08-.09 Balance, speech, vision, hearing slightly impaired; feelings of euphoria, increased confidence; loss of motor coordination.
.11-.12 Coordination & balance becoming difficult; distinct impairment of mental faculties, judgment.
.14-.15 Major impairment of mental & physical control; slurred speech, blurred vision, lack of motor skills.
.20 Loss of motor control - typically need assistance in moving about; mental confusion.
.30 Severe intoxication; minimum conscious control of mind & body.
.40 Unconsciousness, threshold of coma, death possible.
.50 Deep coma, death likely.
.60 Death from respiratory failure.
BAC calculation
Alcohol is “burned up” by your body at .015% (or 1 drink)/hour. To calculate BAC, consider # of drinks consumed, body weight, stomach, gender, time, etc.
Gender Differences in Alcohol Effects
Women get drunk faster than men for 3 reasons:
- They typically weigh less, thus the same amount of alcohol is concentrated in a smaller body mass.
- They typically have a higher % of body fat & less body water. Alcohol dissolves more readily in water. This means that when alcohol enters a woman’s body, it becomes more concentrated, & therefore has a more potent effect.
- An enzyme present in the stomach that metabolizes alcohol is about 4x as active in men as in women.
Summary of Effects: Low Doses
Disinhibition
Social setting & mental state influence response
From euphoric, friendly, talkative to aggressive
Interferes with motor coordination
Summary of Effects: Moderate Doses
Slightly increases heart rate & slightly lowers BP
Slightly dilates blood vessels in arms, legs, skin
Stimulates appetite
Increases production of gastric secretions
Increases urine output
Summary of Effects: Higher Doses
Social setting has little influence on response
Gross motor & cognitive impairment
Induces drowsiness & causes sleep
Basic Effects
Sedative-hypnotic.
Increases skin temperature.
Increases the flow of urine (diuretic) resulting in body dehydration.
In large doses it is an emetic.
Withdrawal Symptoms include hangovers & the DTs.
Delirium Tremens (or the DTs): Symptoms
mental confusion
abnormal perception (errors of interpretation, hallucinations)
disruption of the sleep/wake cycle with insomnia or daytime sleepiness
increase or decrease in psychomotor activity
temporo-spatial disorientation
non-recognition of close family & friends
memory problems
generalized convulsive seizures
Warning Rotations
A 1984 law requires rotation of the following 5 warnings:
- The Surgeon General has determined that the consumption of this product, which contains alcohol, during pregnancy can cause mental retardation and other birth defects.
- Drinking this product, which contains alcohol, impairs your ability to drive a car or operate machinery.
- This product contains alcohol and is particularly hazardous in combination with some drugs.
- The consumption of this product, which contains alcohol, can increase the risk of developing hypertension, liver disease, and cancer.
- Alcohol is a drug and may be addictive.
Task Force on College Drinking - found:
1,400 college students die each year in alcohol related accidents
Motor vehicle accidents were the most common cause of deaths caused by alcohol. Falls & drowning were included but homicides & suicides were not.
In addition, drinking by college students contributes (annually) to:
500,000 injuries
70,000 cases of sexual assault or date rape
400,000 students aged 18-24 had unprotected sex as a result of drinking
Chronic Drinking Effects: CNS
specific & general cognitive impairments.
Chronic Drinking Effects: Liver
minor, reversible damage (with abstinence) to irreversible, sometimes fatal damage (liver toxicity).
Chronic Drinking Effects: Cardiovascular
increased mortality from CHD & increased risk for cardiovascular diseases in general; alcoholic cardiomyopathy.
Chronic Drinking Effects: Endocrine
affects secretion of various hormones.
Chronic Drinking Effects: Gastrointestinal
causes gastritis & increases risk of pancreatitis. Increases risk of contracting the following cancers: oral cavity, tongue, pharynx, larynx, esophagus, stomach, liver, lung, pancreas, colon, & rectum.
Chronic Drinking Effects: Immune
diminished functioning.
Wernicke-Korsakoff Syndrome
Korsakoff’s typically develops as Wernicke’s subsides.
Wernicke’s encephalopathy involves damage to multiple nerves in both the CNS & PNS.
Cause is attributed to malnutrition, especially lack of vitamin B-1 (thiamine), which commonly accompanies habitual alcohol use.
Korsakoff syndrome (or psychosis), involves damage to brain areas underlying memory. The most distinguishing symptom is confabulation (fabrication) where the person makes up detailed, believable stories about experiences to cover the gaps in their memory.
Fetal Alcohol Syndrome (FAS)
The condition was first described in the 70s.
Alcohol produces physical & mental problems in babies of mothers who drink.
FAS is caused by permanent CNS damage. This can create an array of primary cognitive & functional disabilities (including poor memory, attention deficits, impulsive behavior, & poor cause-effect reasoning) as well as secondary disabilities (e.g., predispositions to mental health problems & drug addiction).
Fetal alcohol exposure is the leading known cause of mental retardation in the Western world. In the US & Europe, prevalence rate is ≈ 0.2-2/1000 live births.
Prevalence of drinking among women in the US.
As is typical of consumption rates, WI is at the top.
Signs of FAS may include:
Distinctive facial features (small eyes, thin upper lip, short upturned nose, & lack philtrum.
Deformities of joints, limbs and fingers.
Slow physical growth before & after birth.
Vision difficulties or hearing problems.
Small head circumference & brain size.
Poor coordination
Heart defects
Candida Albicans Drunken Syndrome
Doctor says food may have intoxicated woman:
A physician testified at the drunken driving trial of a 48 year-old woman that food she had eaten the night she was stopped by police may have helped make her inebriated. She had a medical history of someone suffering from Candida albicans drunken syndrome, a gastrointestinal fermentation process that produces alcohol. The syndrome mainly affects women and those with a heavy use of antibiotics and sugar. However, an article in JAMA called the syndrome theory “speculative and unproven.”
Pathological Intoxication
Characterized by repetitive & automatic movements & the occurrences of extreme excitement with aggressive, uncontrolled irrational behavior after ingesting a relatively small amount of alcohol. The episode may last for minutes or hours & is followed by a prolonged sleep with amnesia for the event upon awakening
Conclusion
1-2 drinks a day is good.
Note: 1-2/day is not equal to 14 on the weekend.
And 1 drink = 1 oz whiskey or 4 oz wine or 12 oz beer.
Absinthe
A distilled, highly alcoholic (45–74%) beverage. An anise-flavored spirit derived from the flowers & leaves of Artemisia absinthium (a.k.a. “grand wormwood”), green anise, sweet fennel, & other aromatic herbs.
It is commonly referred to as the green fairy (it may be green or colorless).
It is normally diluted with water prior to being consumed.
Has often been portrayed as a dangerously addictive psychoactive drug. The chemical compound thujone (present only trace amounts) was blamed for its alleged harmful effects.
Whether absinthe has psychoactive effects in addition to those of alcohol has not been conclusively resolved. Its effects have been described by some as mind opening. The most commonly reported experience is a “clear-headed” feeling of inebriation - a form of “lucid drunkenness
Fermentation
C6H12O2 + Yeast -> 2C2H5OH + 2CO2
Glucose Ethanol CO2
Biology - Drug Treatments
≈14 million people in USA (1 in 13), meet diagnostic criteria for alcohol abuse (National Council on Alcoholism & Drug Dependence, 2000). Studies indicate that >50% treated for alcoholism will relapse within 3 months, 75% within 1 year, & 90% within 4 years. Three main drugs: Disulfiram (Antibuse) Naltrexone (Revia & Depade) Acamprosate (Campral)
Disulfiram
Approved in 1951.
Results in illness when patient under treatment ingests alcohol by blocking its metabolism (reaction 2).
The sick feeling is essentially a hangover & includes flushing, throbbing in head & neck, headache, respiratory difficulty, nausea, vomiting, sweating, thirst, chest pain, palpitation, hyperventilation, marked uneasiness, weakness, vertigo, blurred vision, & confusion.
Duration of the reaction is variable, from 30-60 mins in mild cases, to several hours in more severe cases (or as long as there is alcohol remaining in the blood).
Naltrexone
Approved in 1994.
Decreases cravings.
Acamprosate
Approved in Europe since 1989 & in the US since 2004.
Although well tolerated, side effects:
Serious - diarrhea, allergic reactions, irregular heartbeats, & low or high BP.
Less serious - headaches, insomnia, & impotence.
Intended for use in patients who are receiving some form of psychosocial support & have been abstinent from alcohol for at least a few days.
Improves likelihood of abstinence.
May be even more effective when used in combination with naltrexone.
Biology – Genetics
A person with an identical twin who is an alcoholic has a 60% chance of becoming one.
Risk of becoming alcoholic quadruples if a close relative (i.e., mom, pop, &/or sib) is.
While the data are clearly supportive of a role of genetics, heritability varies considerably, depending on factors such as gender, measure of drinking behavior, definition of alcoholism, & population studied.
Alcohol is involved in (1977)
Traffic accidents 50% (still true). Fire fatalities 83%. 53% of victims were alcoholic. Drownings 69%. Falls 63% of injuries. 70% of deaths. Homicides 50%. Suicides >33%. Rapes 50% of rapists. 31% of victims. Assaults 72% of attackers. 79% of victims. Robberies 72% of robbers. Child Abuse 77%. Arrests 33%.
In WI in 2010, at least 1,732 people died, 3,511 were injured, and 67,345 were arrested as a direct result of alcohol use & misuse.
Drunk Walking
Friends shouldn’t let friends walk drunk.
Walking drunk is a risk factor for pedestrian-motor vehicle collisions. It is less studied than and often overshadowed by the dangers of driving drunk.
CDC data from 2008 showed 36% of pedestrians killed in motor vehicle crashes had BACs above 0.08.
Thus, drunk walking accounts for ≈1200-1500 deaths/year.
% Students Reporting Alcohol-Related Problems
Nonbinge Infrequent Frequent
Had a hangover 30 75 90
Regretted a behavior 14 37 63
Forgot what I did 8 26 54
Argued w/ friends 8 22 42
Missed class 8 30 61
Had unplanned sex 8 20 41
Had unprotected sex 4 10 22
Trouble with police 1 4 11
Secondary Effects of Binging
% non-binge drinkers reporting secondary effects (problems due to others drinking) in relation to binge drinking level of school.
% Bingers at School
50%
Insulted or humiliated 21 30 34
Had serious argument 13 18 20
Was hit or assaulted 7 10 13
Had property damaged 6 13 15
Took care of a drunk 31 47 54
Experienced unwanted
sexual advance (women) 15 21 26
