Lecture 9: Alcohol and Inhalants Flashcards
1
Q
what is 1 serving of alcohol? (4)
A
0.6oz, 14 grams of pure alcohol
2
Q
1 serving of beer
A
12 fl oz, 5% alc
3
Q
1 serving of malt liquor
A
8-9 fl oz, 7% alc
4
Q
1 serving of table wine
A
5 fl oz, 12% alc
5
Q
1 serving of shots
A
1.5 fl oz, 40% alc
6
Q
approx how many americans are alcoholics?
A
18 million, 1 in 8
7
Q
males are ___ as likely to suffer from alcoholism
A
2x
8
Q
alcohol problems account for annual expense of
A
$185bn
9
Q
in 2009, how many ER admissions were related to alc use?
A
600,000+
10
Q
is alcohol water or fat soluble?
A
both
11
Q
how much of alc is absorbed in stomach?
A
20%
12
Q
3 variables that most affect alc absorption
A
- presence of food, slows
- volume and concentration of dose
- alcohol is irritant and increases flow of HCl and pepsin
13
Q
how much of alc is absorbed through upper intestine?
A
80%
14
Q
time from last drink to maximal absorp in blood is ___
A
15-60 min
15
Q
95% of alcohol metab by ___
A
alcohol dehydrogenase
16
Q
___ of alc is excreted through lungs
A
5%
17
Q
___ of metab occurs in stomach by ____
A
10-15%; gastric alcohol dehydrogenase enzyme
18
Q
___ in liver and involves ___ enzymes
A
80-85%, P450 enzymes
19
Q
concentration of alc in exhaled air vs venous blood
A
1:2,300
20
Q
women have ___ gastric metbolism, because they have less of ___
A
50%, gastric alcohol dehydrogenase enzyme
21
Q
2 more reasons men have lower BAC
A
- greater muscle to fat ratio, so more places for alc to spread (fat has little blood supply)
- men weigh more
22
Q
alcohol is converted to ___ via ___. coenzyme?
A
acetaldehyde via alcohol dehydrogenase
nicotinamide adenine dinucleotide (NAD)
23
Q
rate limiting step of alcohol metab
A
availability of NAD
24
Q
2nd step of alcohol metabolism
A
aldehyde dehydrogenase converts acetaldehyde to acetic acid
25
what does disulfram do?
irreversibly inhibits aldehyde dehydrogenase, leaving carcinogenic acetaldehyde behind
26
3rd step of alcohol metabolism
acetic acid broken down into CO2 and water
27
it takes ___ to metabolize the amt of alc contained in standard serving
1 hour
28
first threshold for alcohol impairment ; what is its effect?
0.04
| impaired judgment and reaction time, decreased inhibition
29
risk of accident at 0.1-0.14? at 0.15+?
6-7x increased risk
| 25x increased risk
30
2 minor metabolites of alcohol that can be detected even at BAC 0
ethyl glucoronide and ethyl sulfate
31
unitary hypothesis of alc pharmacodynamics. what thing does it account for, and what does it not account for?
alc dissolves in nerve membranes thus distorting membrane like gen anesthetics
1. generalized depressant behavior effect
2. does not account for ability to disturb synaptic activity of glu and GABA and intracellular transduction
32
ethanol potently inhibits ___ receptors for ___
inhibits NMDA glu receptors, leading to decreased cog functioning
33
chronic alcohol use leads to persistent ___ suppression, which leads to
glutamate suppression, leading to compensatory up-reg of NMDA receptors
34
sudden cessation of alcohol leads to excess ___ excitation, which can cause ___
NMDAR
| excitatory neuronal nerve damage and loss due to Ca2+ toxicity
35
alcohol enhances ___, and indirectly
GABA neurotransmission
| augments dopaminergic projection from VTA to NA and frontal cortex
36
4 behavioral effects from stim of GABA receptors
1. sedation
2. muscle relaxation
3. inhibition of cog and motor skills
4. reduced concern about action consequences
37
opioid antagonist that leads to anticraving
naltrexone
38
alc effect on 5HT receptors
augments serotonergic activity in NA (5HT2 and 5HT3)
39
___ reduce drinking in alcoholics of lower severity
SSRIs
40
chronic alc consumption stimulates synth of ___, the NT for ___
anandamide
| cannabinoid receptors
41
anandamide ___ cannabinoid receptors
activates and down regulates
42
alcohol cessation leads to hyperactive ___
anandamide reaction
43
alc fx on respiration
stimulated at low doses, then depresses
44
benefits of low doses of alcohol (3)
1. reduce risk of coronary and peripheral artery disease, because increase high-density lipoprotein and decrease low-density lipoprotein
2. also decreases platelet aggression, protecting heart
3. reduce incidence of ischemic strokes
45
alcohol implicated in ____ of homicides and assaults
over 50%
46
5 results of BAC 0.05-0.09
1. increased sociability
2. decreased inhibition
3. less attn/judgment/ctrl
4. slowed info processing
5. loss of efficiency
47
2 results of BAC 0.25-0.3
1. ability to transcribe memory proteins from genetic material is impaired
2. blackouts
48
alcohol myopia
shortsightedness in which superficially understood, immediate aspects of experience have disprop influence on behavior and cognition
49
in alc dependent adolescents, alc withdrawal leads to ___
persistent poor tretrieval of verbal and nonverbal info
50
binge drinking def
drinking 5+ drinks in a short period for men or 4+ for women
51
3 negative effects of binge drinking
1. wreaks havoc on brain structures related to learning and memory
2. causes impairments in cognitive tasks for days to weeks after binge
3. can cause long term learning deficits mainly due to glutamate excitotoxicity
52
5 brain structures damaged in binge drinking rats
1. hippocampus
2. perirhinal cortex
3. entorhinal cortex
4. piriform cortex/olfactory bulb
5. insular cortex
53
3 types of alc tolerance
1. metabolic
2. tissue/functional
3. associative contingent/homeostatic tolerance
54
what % of tolerance does metabolic tol account for?
25%
55
kindling
repeated withdrawals lead to increase in severity and greater likelihood of seizures
56
2 mechanisms underlying alc amnesia
1. disruption of limbic areas to prevent consolidation of encoded stimuli into lasting memory traces
2. alcohol blocks memory protein formation
57
what is alcohol demtnai?
korsakoff's syndrome; caused by severe deficiency of vitamin B1, leading to chronic memory disorder
58
75% of alcoholism attrib deaths are due to ___
liver cirrhosis
59
is alcohol a carcinogen?
no; it is a co-carcinogen because acetaldehyde promotes tumor growth
60
fetal alcohol syndrome occurs in ___ born to alcoholic women
30-50%
61
5 symptoms of FAS
1. mental retardation/reduced brain size
2. behavioral abnormalities (like ADHD)
3. retarded body growth rate
4. possible congenital heart defects
5. facial abnormalities
62
3 behavioral and cognitive effects of alc exposure (alcoholr elated neurodevelopmental disorder). why?
1. cog dysfunction (impaired intelligence, etc)
2. sensory dysfunction
3. behavioral dysfunction
alc competes with synthesis of retinoic acid, required for normal fetal brain dev
63
___ of youth (14-18 yrs) with problematic drinking exhibit comorbidity for depression, PDs, substance abuse
80%
64
5 treatment strats for alc use
1. reverse acute pharmacological effects (but can't b/c no unitary receptor)
2. treat and prevent withdrawal
3. maintain abstinence
4. treat comorbid disorder
5. limit neuronal damage by blocking w/d induced glutamatergic activation
65
long-acting benzo used in alc w/d
librium, valium
66
fast-acting benzo to prevent acute seizures
lorazepam
67
GABA and NMDA receptor modulator
acamprosate
68
4 pharmacotherapies in dev for alc
1. cannabinoid receptor antag (rimonabat)
2. partial nicotinic agonists (chantix)
3. dopaminergic drugs (wellbutrin)
4. serotonergic drugs (SSRIs)
69
effect of cannabinoid receptor antag; limitations
reduce drinking by inhibiting mesolimbic DA pathway
| low efficacy and side fx like depression and anxiety
70
effect of nicotinic agonists
reduce alc consumption and rate of relapse
71
effect of dopaminergic drugs
alcohol w/d causes hypofunction of mesolimbic DA system, may treat depression
72
7 interacting NT sys in alcoholism
1. opioid
2. dopaminergic
3. serotonergic
4. endocannabinoid
5. nicotinic
6. GABA
7. glu
73
primary fx of sys on alcoholism: opioid
reinforcing and craving
74
primary fx of sys on alcoholism: dopaminergic
reinforcing, craving
75
primary fx of sys on alcoholism: serotonergic
affective dysreg
76
primary fx of sys on alcoholism: endocannabinoid
craving, relapse
77
primary fx of sys on alcoholism: nicotinic
reinforcing
78
primary fx of sys on alcoholism: GABA
reinforcing
79
primary fx of sys on alcoholism: glu
cognitive functioning
80
who is most likely to abuse inhalants?
12-17 years; more 12 year olds used inhalants than other drugs
81
3 reasons inhalants are popular
1. low cost
2. available
3. rapid onset
82
7 acute effects of inhalants
1. intoxification
2. disorientation
3. slurred speech
4. impaired judgment
5. euphoria
6. dizziness
7. delirium
83
sudden sniffing death syndrome
lack of oxygen to brain, cardiac arrhythmias, aspiration of vomit, trauma, frozen lungs; contain volatile hydrocarbons, which sensitive heart to serious arryhtmias. if startled while intoxicated, sudden adrenaline surge acts on heart to set off life-threatening arrhythmias
84
8 effects of long term inhalant use
1. liver and kidney failure
2. dementia
3. cog dysfunction
4. loss of coord
5. weight loss
6. muscle weakness
7. irritability
8. depression
85
primary acute treatment for inhalants
supplemental oxygen
86
5 treatment approaches for inhalants
1. detox
2. medical/neurological eval
3. neurocog assessment and rehab
4. occupational/physical therapy
5. afterschool care
