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Psychopharmacology > Exam 3 - Alcohol Abuse > Flashcards

Exam 3 - Alcohol Abuse Flashcards

1
Q

Addiction

A

chronic relapsing disease characterized by compulsive drug-seeking and abuse and by long lasting structural and functional changes in the brain

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2
Q

What was the Pure Food and Drug Act (1906), and the Harrison Narcotic Act (1914)?

A
  • prohibited the sell of alcohol
  • had to have a license to market or sell drugs
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3
Q

What are the different schedules of drugs?

A

Schedule 1 - high risk for abuse and no therapeutic use
Schedule 2 - high risk for abuse and some therapeutic use
Schedule 3 - lower risk for abuse
Schedule 4 - even lower risk for abuse
Schedule 5 - lowest change of abuse

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4
Q

What 4 things usually occur in substance abuse?

A
  1. failure to fulfill major role obligations and work, school, or home
  2. recurrent use in situations that are physically hazardous (drinking and driving)
  3. recurrent substance-related legal problems
  4. continued substance use despite persistent or recurrent social or interpersonal or exacerbated by substance (getting in fights with friends and family)
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5
Q

Substance dependence is characterized by? (DSM-5)

A
  1. tolerance
  2. withdrawal symptoms
  3. greater intake of substance
  4. persistent desire or unsuccessful attempts to cut down
  5. significant time spent using, obtaining, or recovering
  6. giving up or reducing important social activities
  7. continued use despite knowledge of its negative effects
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6
Q

Who is substance dependence common in?

A
  • young (18-25 yo) men
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7
Q

What are the 3 personality dimensions that could influence alcohol dependence?

A
  • risk taking and sensation or novelty seeking behavior
  • lack of emotional control
  • interpersonal relatedness (attachment style,)
  • mental health
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8
Q

What family factors contribute to alcohol dependence?

A
  • parental substance abuse/dependence
  • parental personality/psychopathology
  • parent-offspring relationship
  • sibling influences
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9
Q

What are the developmental factors that could contribute to alcohol dependence?

A
  • peer influences, may seek out friends that do that, or fall victim to peer pressure
  • marital partner relations and occupational status (single/divorced) and occupational status
  • educational status
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10
Q

What contextual influence could contribute to alcohol dependence?

A
  • low socioeconomic status (residence in impoverished and stressful neighborhoods, drug-salient milieu, social disorganization)
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11
Q

What is the physical dependence model of addiction?

A
  • initial drug use -> repeated drug use -> physical dependence -> attempts at abstinence -> withdrawal symptoms -> relapse
  • once physically dependent, attempts at abstinence lead to withdrawal symptoms
  • negative reinforcement - continued use to avoid withdrawal
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12
Q

What is the positive reinforcement model of addiction?

A
  • initial use -> positive reinforcement -> repeated drug use -> attempts at abstinence -> compulsive desire for euphoria -> relapse
  • support for this model comes from the self-administration paradigm
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13
Q

What is the incentive sensitization model?

A
  • initial use -> positive reinforcement -> repeated use -> sensitization of drug wanting but not liking -> attempts at abstinence -> compulsive desire for the drug due to a sensitized incentive salience system -> relapse
  • repeated exposure can change brain cells and circuits that normally regulate the attribution of incentive salience to stimuli
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14
Q

Opponent-process model of addiction

A
  • initial use -> positive reinforcement -> repeated use -> sensitization of drug-induced hedonic response but loweing of the hedonic set point -> attempts at abstinence -> compulsive desire for the drug due to dysphoria and sensitized drug salience -> relapse
  • the longer you’re on a drug, the less of a high you get, and you get more wtihdrawal
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15
Q

Disease model of addiction, susceptibility models

A
  • inherited susceptibility to uncontrolled drug use/initial drug use -> repeated drug use -> loss of control
  • addiction models - addiction comes from an inherited susceptibility
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16
Q

Disease model of addiction, exposure models

A
  • initial use ->repeated/chronic use -> altered brain function -> loss of control
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17
Q

Who is the highest prevalence of binge and heavy drinking in?

A

young adults - 18-25

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18
Q

What is the first phase of alcoholism?

A
  • pre-alcoholic phase:
    • drinking for social reasons
    • anticipated stress reduction and relief from psychological pain/tension
    • individual seeks out drinking occasions, increases consumption
  • becomes part of daily living
  • begin to develop tolerance
19
Q

What is the second phase of alcoholism?

A
  • prodromal phase:
    • develops feeling of guilt about drinking
    • need for increased intake (tolerance)
    • physiological dependency is established (withdrawal)
    • may also experience black outs, and begin to lose control
20
Q

What is the third phase of alcoholism?

A
  • crucial phase
    • solitary drinking
    • may restrict consumption, but this is temporary
    • reverse tolerance (need less drinks to get desired effect)
    • may have nervous or GI disorders, cirrhosis, malnutrition
    • personality deterioration
21
Q

What is reverse tolerance indicative of?

A

liver damage

22
Q

What is the fourth phase of alcoholism?

A
  • chronic phase
    • develops after years of excessive intake
    • medical complication may require institutionalization or death may occur
23
Q

What stages of alcoholism could an alcoholic enter remission?

A

stage 2 or 3

24
Q

What are the sites of action of alcohol?

A
  • decrease amplitude of AP, decreasing NTs released
  • depressant of the CNS, capable of entering every cell in the body
  • alter cell membrane anatomy by entering internal structure
25
Q

Pharmacokinetics of alcohol: absorption

A
  • passes from the stomach to the small intestine for rapid absorption
  • rate is affected by: variability among individuals, and stomach content
26
Q

What is the distribution of alcohol affected by?

A
  • can cross BBB, and blood distributes alcohol to all body tissues
  • LD 50 of alcohol is about 25 drinks
27
Q

BAC, what factors affect it?

A
  • blood alcohol concentration
  • amount of alcohol in the bloodstream, % of weight of alcohol per 100 units of blood volume
  • total body mass, differences in the rate of metabolism
28
Q

What is the process of breaking down alcohol?

A
  • alcohol dehydrogenase + alcohol = acetaldehyde + acetaldehyde dehydrogenase = acetic acid
  • cytochrome P450 family of enzymes from liver also aid
29
Q

Chronic use of alcohol increases what enzymes? What happens because of this?

A
  • alcohol dehydrogenase and P450
  • reduces BAC, increases metabolism
30
Q

What are the phases of dependence?

A

Phase 1: occurs after a few hours after drinking (agitation, nausea, vomiting)
Phase 2: onset is w/n 24 hours of after drinking (risk for seizures)
Phase 3: about >30 hours after drinking, may last 3-4 days, commonly called delirium tremens

31
Q

What is alcohol withdrawal syndrome?

A
  • fever, hallucinations, hypertension, incapable of thinking, cardiovascular collapse
32
Q

What are the acute affects of alcohol?

A
  • inhibits secretion of antidiuretic
  • reduces amount of fat that is oxidized (beer belly)
  • disrupts sleep patterns
  • impairs memory
  • causes slight respiratory depression
33
Q

What are the sensorimotor affects of alcohol?

A
  • vision acuity decreases, taste and smell are not as sensitive
  • reaction time slows
  • impairs psychomotor skills
  • impairs driving abilities
34
Q

What are the psychological effects of alcohol?

A
  • alters emotion and mood (low doses increase mood, high doses decrease mood)
  • correlated with aggression
35
Q

Can alcohol damage the brain?

A

yes, it can cause overall atrophy

36
Q

What can alcohol do to the liver?

A
  • fatty liver
  • cirrhosis
  • alcohol hepatitis
37
Q

Fetal alcohol syndrome

A
  • children have physical deformities
  • also show low-normal to sever impairments of intellectual functioning
38
Q

What are the specific effects of alcohol on neuronal membranes?

A
  • acts at a NT
  • modifies gating mechanism inside channel
  • stimulates Gs which is linked to adenylyl cyclase
  • direct interaction with channel protein
39
Q

What are the nonspecific effects of alcohol on neuronal membranes?

A
  • disturbs the relationship of protein in membrane
  • interacts with polar heads of phospholipids
  • alters lipid composition
40
Q

What NTs does alcohol act on?

A
  • Glutamate: inhibits, reducing effects of NMDA receptor (cause for amnesia)
  • GABA: modulates function, withdrawal can cause seizures
  • Dopamine: increases transmission in mesolimbic pathway (reward pathway)
41
Q

What system is highly sensitive to alcohol? Explain.

A
  • opioid system
  • causes release, which is why you don’t feel as much pain
42
Q

Modern treatment for alcoholism is considered in 3 stages, what are they?

A
  1. detoxification (ridding the body of alcohol, drying it out)
  2. medical care for health problems
  3. changing long term behavior (psychotherapy, family therapy, AA)
43
Q

What 3 main drugs are used in alcoholic treatments?

A
  • disulfiram (antabuse - interferes w/ metabolism, makes them sick)
  • naltrexone - anticraving
  • benzodiazepines (valiums, helps with seizures, anxiety, and anger)
  • antidepressants

Psychopharmacology (16 decks)

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