Exam 4 Flashcards
What are the types of alcohol?
Beer, Wine, Distilled Spirits
What is proof?
A type of measurement of alcohol and is just 2x the % of alcohol
How do we calculate alcohol in a drink?
The # of oz and multiply by the corresponding alcohol % as a decimal
What is the amount of alcohol in a beer?
5-7%
What is the amount of alcohol in a wine?
12-14%
What is the amount of alcohol in a distilled spirit?
40-50%
What is fermentation?
The process of making wine by converting natural sugars into ethyl alcohol by using yeasts
Yeasts will break down the sugar and create a fermented product.
Why cant fermentation become more concentrated than 12-14%?
It cannot get more concentrated because too much alcohol will kill yeasts and if they are killed, they won’t make anymore alcohol so it’s concentration will not increase
What is brewing?
A process that makes beer from barley grain
What is distillation?
The process that makes liquor. We place fermented products in the chamber and boil alcohol with water. Since alcohol boils faster it will create a steam that travels and as it cools creates a concentrated liquor.
Alcohol is more soluble in ______ than ______ (dissolves in both)
Alcohol is more soluble in water than fat
How long (after they drink) would it take for BAC to peak?
30-90 minutes
What happens when someone drinks on an empty stomach?
They absorb 20% more alcohol because our stomach will immediately begin to be absorbed as it moves into our small intestine. The remaining 80% is absorbed in the small intestine.
What is BAC?
Blood-Alcohol Concentration
What is alcohols half-life?
It does not have a half life, it will gradually decrease in a steady state
About ___ of alcohol is broken down by ________?
About 95% of alcohol is broken down by Alcohol Dehydrogenase
About ___ of alcohol is unmetabolized and can come out through _______
About 5% of alcohol is unmetabolized and can come out through respiration
The alcohol that is broken down is mainly broken down where?
In the liver
What is first pass metabolism?
This is when a drug is broken down in the body before it hits the bloodstream
Which drug does first pass metabolism affect?
Alcohol, if the stomach is full, alot more first pass metabolism will occur and break down more of the alcohol because metabolism will be slowed down by contents
Where does most of the alcohol come out from?
Urine
What is oxidation?
The process of metabolization where alcohol is broken down by alcohol dehydrogenase and be converted into acetaldehyde. Then, acetaldehyde will be broken down by aldehyde dehydrogenase and convert it into acetic acid. Acetic acid breaks down even more and converts into CO2, water, and energy.
About how many drinks are broken down every hour?
One drink
t/f our body cannot oxidize alcohol as it enters
False, it can. If we drink it slowly, we will have little to no effects because our body keeps up regulation
What is the legal limit for DUI?
0.08 BAC
How do we calculate BAC using weight, drinks and time after?
We use the chart to find the BAC for the weight. We will then get a BAC value but we will have to multiply 0.015 * the number of hours because some metabolization has occurred. After that, we subtract the amount of metabolization by the original BAC
How does solubility relate to alcohol’s mechanism of action?
Because of this is can function like general anesthetics. It will cross the membranes of neurons very easily and cause the terminal buttons to swell.
How does alcohol function like an anesthetic?
It can cause terminal buttons to swell. If they swell, the amount of neurotransmitters that are released can cause the central nervous system to be suppressed
What neurotransmitters does alcohol mainly affect?
Glutamate, GABA, and serotonin
How does alcohol affect glutamate?
it will reduce the release of glutamate (excitatory) and act as a sedative/depressant
How does alcohol withdrawal induce seizures?
Glutamate will produce upregulation because alcohol inhibits its receptor. When someone quits drinking there is an abundance of receptors. Glutamate will be released again and it can overexcite the brain.
How does alcohol affect GABA?
GABA channels are stimulated by alcohol. Some evidence suggests that alcohol binds and activates the same sites as Benzodiazepene which functions as a CNS depressant
How does alcohol affect serotonin?
We are finding that blocking serotonin (with other drugs) can potentially lessen the cravings
What is expectancy?
It is what someone expects to happen when they are on drugs. It will guide how they feel and their experiences while on drugs
What is behavioral inhibition?
It is the mechanism (frontal lobe) that acts as a filter. Since alcohol is a depressant, this filter will be decreased
How do police test if drivers under the influence?
By assessing their motor function
What cognitive function does alcohol affect?
Memory, people usually blackout and wont remember what happened when intoxicated
Attention, concentration, and processing is also impaired
Is hallucination common in alcohol users?
Only when they have a long history of drinking high doses
What is confabulations?
This is when high alcohol users present memory issues but instead of admitting it, they will make stuff up.
Why do blackouts happen?
This usually happens when someone drank too much too quick.
What type of sleeping is affected by alcohol?
REM sleep.
What happens when people are deprived of REM?
They tend to feel bad,poor cognitive function, etc
What is aphrodisiac?
it is when a substance induces sexual behavior. Alcohol is thought to do this. Although they have a sexual desire, that does not mean they can perform it
Why is nausea and vomitting common with alcohol?
Because it is a gastric irritant.
When does loss of consciousness occur?
At high doses of alcohol
What happens if someone is unconscious and vomiting?
They can die from asphyxiation because they can breathe the vomit in the lungs.
How does alcohol affect dehydration?
Alcohol is a diuretic meaning its chemicals increase urine (more water comes out of body)
What is the antidiuretic hormone?
It is produced in the hypothalamus and released by pituitary gland. Alcohol blocks it and by doing so, it causes urine to be released instead of staying in the body.
What are congeners?
Chemicals in alcohol that give color and tase but can cause hangover symptoms
Why is it bad to take acetaminophen?
It is an analgesic (like tylenol) and it is very bad for our liver.
Why is it bad to take ibuprofen?
Because it can irritate the stomach and is a blood thinner
Alcohol increases the chance of which heart problem?
Cardiac arythmia
What are the effects of small amounts of alcohol and HDL?
It can increase HDL ( good cholesterol) which is a benefit
What are the effects of low amounts of alcohol on the blood?
Alcohol thins the blood so it reduces the risk of stroke and can reduce the risk of diabetes mellitus and vascular dementia
What types of tolerance is there to alcohol?
metabolic, functional and environmental
What is metabolic tolerance to alcohol?
The liver will start to increase enzymes that break down alcohol. Chronic alcoholics will have a hard time because there will be reverse tolerance here
What is functional tolerance to alcohol?
Over time, neurotransmitter will not be as responsive to the same amts of alcohol
What is environment tolerance to alcohol?
Our body can regulate metabolic processes depending on where you are. If you are in a place that you know has alcohol, it can begin metabolic processes sooner
What neurotransmitter has an effect on dependence?
Dopamine
What is delerium tremens?
A withdrawal syndrome that includes hallucination, confusion, sleep disorders
What is binge drinking?
5 drinks or more in a row for men
4 drinks or more in a row for women
Can binge drinking lead to alcoholism and abuse?
Yes
What is type 1 Alcoholics?
It is when people tend to develop drinking problems later in life (30-40) and generally function well in society. There is a strong environmental factor that led them to drinking. They are also more likely to binge
What is type 2 Alcoholics?
It is people who developed drinking problem early in life (under 25) and function poorly in society.There is some genetic factor and these people don’t binge, they drink consistently
How does alcohol function in people of asian descent?
Alot of people of Asian descent lack acetaldehyde dehydrogenase and possibly alcohol dehydrogenase so when they drink, the effect of acetaldehyde will be higher. This is why they are less likely to be alcoholics because it is not rewarding for them
Identical twins share how much genes?
100%
Fraternal twins share how much genes?
50%
Type2 alcoholism is more common in ______
Men
Does an alcohol gene exist?
No some people are just exposed to alcoholism at an early age
What liver diseases can alcohol cause?
Fatty liver, alcoholic hepatitis and cirrhosis
What is fatty liver?
When fat deposits in the liver (most liver-alcohol deaths are from this)
What is alcoholic hepatitis?
When the liver becomes inflammed
What is cirrhosis?
When the liver has scarring and deterioration of cells (7th most common cause of death in US)
Is cancer associated with alcohol?
Yes, anywhere from mouth to rectum, it can even cause breast cancer for women
What is dementia?
A general term for cognitive impairment due to changes in the brain
What is alcoholic dementia?
Structural changes in the brain (shrinkage in some parts), lower IQ, decline in verbal
What is Wernicke’s disease?
It is a disease that causes confusion, memory issues, disorientation,etc and was thought to be specifically associated with alcohol
What deficiency does Wernicke’s disease cause?
Vitamin B1 (Thiamine)
What is Wernicke Korsakoff?
A disease that results in retrograde and antergrade amnesia
What part of the brain is affected by Wenicke Korsakoff?
Thalamus
What does Wernickes Korsakoff do to our brain?
It can increase the size of ventricles, meaning smaller brain, and the sulci (grooves) of the brain are wider
What is antabuse?
Used to be a common prescription for alcoholism suppression but people just tend to not take it because it causes bad symptoms
What is Revia and Revex?
Drugs that reduce craving and are opiate receptor antagonists (less reward)
How does Zofran help with alcohol treatment?
It blocks serotonin receptors and decreases cravings
Alcohol withdrawal comes in which 2 parts?
First cluster: comes within the first few hours to a day after someone quits
Second Cluster: After first cluster, includes severe symptoms
How long for alcohol withdrwala symptoms to reside?
5-7 days
What is fetal alcohol syndrome?
A disease affecting babies due to alcohol use during pregnancy
What is the diagnosis of FAS based upon?
Pre and post natal growth deficiencies and facial dysmorphology
What is fetal alcohol spectrum disorder?
Those that have some symptoms of FAS but not all fall in a spectrum
What is meant by analgesics?
It is a term used to describe a drug that combats pain
What is opium?
A chemical that came from a poppy and is only available for a few days of the plants cycle (opium is in the seed pods)
What two main substances are in opium?
Morphine and Codeine
What is more potent? morphine or opium?
When isolated, morphine is more potent
Who developed the hyperdermic syringe for medical purposes?
Dr. Alex Wood
What schedule is morphine?
Schedule 2
What schedule is opium?
Schedule 2
How was heroin made? From what?
Heroin comes from morphine and it is basically morphine attached to 2 acetyl groups
Another name for heroin is?
Di-acetyl-morphine
Who first marketed heroin?
Bayer
Which is more potent? Heroin or morphine?
Heroin is 3x more potent than morphine
Heroin was used in what war?
Vietnam
Heroin is scheduled?
Schedule 1
Black tar heroin was used in the ______ and white china was in the _______
Black tar heroin was used in the west coast and white china was in the east coast
What is the name of the natural opiate like chemicals in our brain?
Enkephanlins and endorphins
Where in the brain are most of the opiate receptors?
Periaqueductal gray
How is pain reduced?
When opiate receptors bind to either drugs or endorphins, the signals will travel down our spine and activate the neurons to suppress the incoming pain signal
Fentanyl is what type of opioid?
Synthetic
Fentanyl is more potent than?
100x more than morphine so more than heroin and opium
What is actiq?
Lollipop form of fentanyl
How do opiates help with intestinal disorders?
If dysentry (diarrhea) is occuring, it can slow the movement of food and allow the feces to come out slower. If you take them and dont have this issue, you can get constipated
What are antitussives? What group of drug falls in here?
Opiates are antitussives (cough suppressant)
What part of the brain control cough center?
Medulla (suppressed by opiates)
Which opiate is usally in cough syrups?
Codeine
What is the alternative to codeine?
Dextromethorphan (DMT)
How is morphine absorbed?
Oral, IV, Rectal, or as an epidural
Does morphine cross the Blood brain barrier well?
No, only 20% reaches the blood stream
What is morphine’s metabolite?
Morphine-6 glucoronide (stronger than morphine)
What can cause a false positive for morphine?
Eating a lot of poppy seeds
What schedule is codeine?
Schedule 3
How is codeine absorbed?
Intramuscular, Subcutaneously
Why cant codein be injected IV?
It can cause pulmonary edema
Which is stronger codeine or morphine?
Morphine
What are the 3 types of heroin?
Brown, white and black tar
Why is heroin more potent than morphine?
Because the acetyl group increase the lipid solubility and gets more easily into blood brain barrier
How is heroin absorbed?
Smoked, IV, snorted
What is an air embolism?
It is a risk from injecting heroin and an air bubble is injected as well. This can cause surface tension and lead to a clot
How is dependence of opiates?
Dependence is very strong both physical and psychological. it occurs rapidly because there is alot of positive reinforcement, but it does not occur after only one use.
How is tolerance of opiates?
Tolerance develops depending on the dose and frequency but even people who use it medically can have tolerance
What are the 2 main reasons heroin users OD?
- Buying from a new dealer
2. Using heroin in a new environment
What is the narcotic triad?
This is the 3 general symptoms of someone who is OD from opiates
- coma
- depressed respiration
- Pinpoint pupils
Which drug can reduce the risk of death during OD?
Narcan (nalaxone)
What is krokdil?
AKA desomorphine and it is a drug that can cause lots of skin problems including Gangrene and necrosis
Krokodil is made with which substances?
Codeine, HCl, gas, paint thinner, etc
At high rates, what can krokodil cause?
Rotting gums, bone infection, facial and jaw decay,
What is kratom?
A drug that comes from a tree in SE Asia and can be smoked, power, gum, tea,etc
What schedule is kratom?
The DEA made it schedule 1 but reversed it. In some parts it is illegal in others it isn’t
What are the 2 main ways to administer General Anesthesia?
Inhalation and injection
What is ketamine?
A drug mainly used in animals but in hgih doses can be used as a date-rape drug
Ketamine blocks which receptor?
Glutamate
Rohypnol is part of which class of drugs?
Benzodiaepines
What schedule is Rohypnol?
Schedule 4, not FDA approved
What is GHB?Where is it?
Gamma-hydroxybutric acid is a potent CNS depressant that is similar to GABA. We all have it in our brain
What is GHB used for?
Date-rape drug, (has a salty taste) or for body builders to increase mass
What schedule is GHB?
Schedule 1
Which FDA treament is currently used and is similar to GHB?
Xyrem, it is a schedule 3 drug and is used for narcolepsy patients
What can we say about GHB’s lethal and effective dose?
There is a very small distinction between the 2 so it is very dangerous
What are nitrites?
Chemicals that dilate blood vessels and relax muscles
What are nitrites used for?
Often abused and used as sexual enhancers
What are the effects of nitrites?
They increase sexual behavior, deplete immune cells and can increase risk of tumors
What is nitrous oxide also known as?
Laughing gas
Who is given credit for laughing gas (nitrous oxide)?
Sr. Humphrey Davis, Thomas Beddoes, and James Watt
What is whippets?
A way of abusing an inhaling nitrous oxide. It causes a short high but if we take too much, it can cause oxygen depletion
Teens mainly rely on ________ to get a high because it is accessible
Inhalants
What effect does nitrous oxide have on neurotransmitters?
Decreases neurotransmitters
What are the medical consequences from inhalants?
-heart issues, sudden sniffing death, sphyxiation, suffocation, neurotoxicity, damage to myelin
What is sudden sniffing death syndrome?
Right after inhaling a product, the person will die
What is neurotoxicty?
Shrinkage of the brain related to cognitive issues, physical issues, etc
