Lecture 3: Ethyl Alcohol

Question 1

Alc is the BLANK most used BLANK in the world

Answer 1

second, psychoactive substance

Question 2

What are some characteristics of alcohol? drink amount and burn-off rate

Answer 2

one drink = 10 cc (1/3 oz) 100% ethanol
Body reduced BAC by 0.015g% in 1hr (rate limiting step)
Types: beer, spirits and bubbly
Soluble in both water and fat - higher absorption in women
BBB and placental barrier are permeable to alc

Question 3

Where is alc absorbed in the body?

Answer 3

Esophagus
Stomach - 20%
Upper intestines - 80%
Lower intestines

Question 4

What ezyme is alc metabolized by? where does it occur and in what percentage (2 places)?
What is the max EtOH metabolized in 24hr?

Answer 4

1. 95% of alc is metabolized by alc dehydrogenase
2. 85% of metabolism occurs in the liver
3. 15% by first-pass metabolism - may differ based on stomach contents
   170g, or 7-8g of 100% per hr (1 drink per hr)

Question 5

How does one calculate BAC? what variables are needed?

Answer 5

Consumption and body weight (hours, drinks, body weight)

BAC of 0.08 = intoxicated

Question 6

What drug can be given to help treat alcoholism?

Answer 6

Acetaldehyde - induces illness when alc is consumed

Question 7

Why are their gender differences in alc tolerance?

Answer 7

Women have a lower level of gastric al dehydrogenase
Men have a greater ratio of muscle/fat (larger vascular compartment - larger volume of blood to take in alcohol/dilute alc)
Women have higher body fat, this concentrates alc in plasma

Question 8

Which systems/processes are effected by alc?

Answer 8

glutamate s
gaba s
intaracellular transduction p

Question 9

What are the pharmacodynamics of GluR?

Answer 9

Inhibits NMDA receptors (lowers excitation) - chronic exposure = up-regulation of NMDAR
Withdrawal can lea to hyperexcitability (2 much NMDA = seizures)
Acamprosate (structurally similar to glutamate)

Question 10

What are the pharmacodynamics of GABA?

Answer 10

Activates GABAR - results in neuronal inhibition, depressant qualities are chemical, hype is psychological

Binds to specific site on GABAaR - may reduce anxiety and panic, GABA agonistic action linked to positive reinforcing effects of the drug

Question 11

What is the relevance of opiod/opiod receptors in alc dependence? what can be given to mitigate this?

Answer 11

Alc dependents & offspring show deficit in opioid activity
Subconsciously consuming to increase opioid activity
EtOH induced opioid release, dopamine release

Naltrexone blocks opioid release, reduces craving

Question 12

What are the pharmacodynamics of 5-HT receptors?

Answer 12

Agonistic action on 5-HT2-3 located on DA neurons in nucleus accumbens (part of dopamine reward pathway), antagonist drugs block these receptors reduce EtOH intake
5-HT transporter dysfunction may be involved

Question 13

What are the pharmacodynamics of cannabinoid R?

Answer 13

chronic exposure leads to formation of endogenous NT anandamide - which activates cannabinoid receptor = possible down-regulation
Abstinence lead to hyperactive receptor activation, promotes cravings

Question 14

What are the pharmacological effects of EtOH? what are some positves?

Answer 14

Graded reversible depression of behavior and cognition
Depression of respiration - chronic exposure can stop breathing
Additive effects with other sedative-hypnotic compounds
Reduction in circulatory function, dilates blood vessels

2-3 times a week of a decent wine

• low doses reduce risk of coronary artery disease and stoke
• increases in HD-lipoprotein (good fats) and HD-cholesterol (good chol)

Question 15

What are the psychological effects of EtOH?

Hint: 3 activation effects

Answer 15

Intoxication associated with violent crimes - fights, rape and sexual assault
Alc is implicated in more than half of all homicides
Activation in GABA system - reduces anxiety
Activation in DA system - impulse control is reduced, increases aggression
Depression of glutamate system - impaired cognitive function, alc myopia, cognitive and attentional deficits

Question 16

What are the variables affected tolerance and dependence? what are the different types of tolerance (3)?

Answer 16

Amount of ingestion, pattern of consumption, individual differences

Metabolic tolerance, tissue/functional tolerance, homeostatic tolerance (environmental)

Question 17

What are the side effects and toxicity during acute use? high doses/chronic use?
what are the physical manifestations?

Answer 17

1. Clouded sensorium
   Impaired judgement
   Anterograde amnesia (blackouts - moment of consumption onwards)
2. Delusions
   Hallucinations
   Unconscious
3. Liver damage (cirrhosis)
   Dementia (nerve damage)
   Wernicke korsakoff’s syndrome (above symptoms and more)
   Digestive problems (pancreatitis, chronic gastritis)
   Cancer (indirect contributor)

Question 18

What are some teratogenic agents?

Answer 18

ethyl acl, ionizing radiation, thalidomide, lithium

Question 19

What are some facts about fetal alc syndrome?

Answer 19

Effects 30-50% of infants born to alc women (3-5 per 1000 births) - irreversible
Threshold is unknown but 3oz of absolute EtOH daily increases risk of FAS significantly
CNS damage and physical deformities

Question 20

What are the three primary features of FAS?

Answer 20

structural, neurological, functional

low IQ, CNS dysfunction, FAS facial/body features

Question 21

What are some facts related to alcohol related neurodevelopmental disorder?

Answer 21

Effects are seen in 1 out of 100 live births, lesser degree of damage than FAS = milder symptoms
- hyperactivity, aggressive behavior, sensory problems, low IQ

Question 22

What are the primary treatments for alc dependency withdrawals? What is best?

Answer 22

Benzos - for acute alc withdrawal, increases GABA activity, remove symptoms (seizures, dts), sedation, psychomotor deficits, interactions with EtOH dependence

Antipsychotics - alleviate DT and hallucinations, lower threshold for seizure, withdrawal seizures

Anticonvulsants - used in place of benzos, fewer side effects, ma contribute to liver/pancreatic problems
(topamax effective in treating alc dependency)

Combination = best

Question 23

How can you maintain abstinence/prevent relapse? (drugs)

Answer 23

Alc sensitizing drugs - antabuse
Opioid antagonists - naltrexone
Acamprosate - GABA agonist, inhibits GluR
Dopaminergic drugs - wellbutrin (comorbid with depression)
Serotonergic drugs

Question 24

Resources offered by campuses to prevent alc abuse…

Answer 24

Preventative campaigns
Counseling
Campus regulations
Enforcement

Question 25

What is the correlate between age and abuse and campus prevelance?

Answer 25

2004 Canadian addiction survey (CCSA)
- YA drink more than people over 25
- students drink more than general population aged 18-24
Early exposure impacts addiction - threshold lies prior to 17 years (25% change of becoming addict, 34% for 13 y/0)

Question 26

Why are young people more prone to alc addiction?

Answer 26

Differences linked to DA sensitivity - young brains spike faster/more
Adolescent brain may be more sensitive to VTA (Validated in in vitro mouse studies)

Question 27

How does a breathalyzer indirectly measure BAC? what is the math here?

Answer 27

EtOH transfers from blood to alveolar sacs in the lungs - in an exhale there is BRAC (breath alc concentration)
Can predict BAC from known ratio (BAC 2 BRAC) = .08 over .2

Question 28

What are the different types of devices to measure BAC?

Answer 28

Breathalyzer: Chemical reaction - color change
Intoxilyzer: infared spectroscopy
Alcosensor III or IV = chemical - fuel cell

Question 29

What is the composition of a breathalyzer?

Answer 29

breath acquisition - mouthpiece
Chemical substrates - glass vials
Photocells & meter - detection

Question 30

What is the process of a breathalyzer reaction?

Hint: 4 a agents - 1 is a product

Answer 30

Potassium dichromate - receive agent, changes colour
Sulfuric acid - helps coax alc out of breath
Silver nitrate - catalyst
Product - chromium sulfate

Question 31

What are some potential sources of error with breathalyzer tests?
What are some breathalyzer myths?

Answer 31

Air temperature
Breathing rate (running lowers (11-14), breath hold bumps up (15) percentage of alc detected
Burping - higher, big expulsion of air that pushes out alc

Disguise odor with food
Chew gum or use mouthwash (experiment suggest mouthwash creates false positives)