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Use and Abuse > Tobacco Smoking, Nicotine and Alcohol > Flashcards

Tobacco Smoking, Nicotine and Alcohol Flashcards

1
Q

Name 3 cancers that smoking is associated with.

A

Head / Neck cancer
Lung cancer
Leukaemia (blood cancer that affects cells in the bone marrow)
Stomach cancer
Kidney cancer
Pancreas cancer
Colon cancer
Bladder cancer
Cervix cancer
(Lecture 20, Slide 3)

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2
Q

Name 3 chronic diseases that smoking is associated with.

A

Stroke
Blindness
Gum infection
Aortic rupture (tear of layers in the wall of the aorta)
Heart disease
Pneumonia (inflammation of the lungs)
Hardening of the arteries
Chronic lung disease and asthma
Reduced fertility
Hip fracture
(Lecture 20, Slide 3)

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3
Q

Why are e-cigarettes safer than smoking?

A

E-cigarettes contain nicotine which doesn’t cancer, but not cancer causing tobacco
(Lecture 20, Slide 5)

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4
Q

What is the mechanism of action of nicotine?

A

It crosses the blood-brain barrier and binds to nAChRs ( nicotinic acetylcholine receptors) and activates them, mimicking the effects of acetylcholine.
(Lecture 20, Slide 9)

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5
Q

Name 3 withdrawal symptoms of nicotine.

A

Anxiety
Anger
Restlessness
Sleepless
Focusing difficulty
(Lecture 20, Slide 10)

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6
Q

What is the approved medication to cease smoking?

A

Nicotine replacement therapies (NRT)
(Lecture 20, Slide 11)

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7
Q

What is the smoking cessation medication with the highest efficacy?

A

Bupropion combined with nicotine
(Lecture 20, Slide 12)

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8
Q

What is the dependence of alcohol?

A

Few alcohol drinkers are dependent (very low dependency)
(Lecture 21, Slide 2)

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9
Q

What are 3 examples of the social cost of alcohol?

A

Alcohol is a decent chunk (11%) of A&E admissions, a huge margin of assault cases (70%) and costs billions annually
(Lecture 21, Slide 4)

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10
Q

How much pure ethanol is in a unit of alcohol?

A

8g
(Lecture 21, Slide 6)

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11
Q

How much volume does the pure ethanol in a unit of alcohol occupy and why is this?

A

Ethanol is less dense than water, so there is about 10 ml of pure ethanol per unit
(Lecture 21, Slide 6)

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12
Q

How is the number of units in a drink calculated?

A

Volume of drink (mls) / 1000 * % alcohol
(Lecture 21, Slide 6)

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13
Q

What is the degrees proof measure of alcohol?

A

% alcohol strength compared to a standard where 57.1% alcohol (vol/vol) = 100° (degrees) proof

ie whiskey, with an alcohol content of around 40% vol/vol is 70° proof (as 40/57.1 = 70% of the strength it would need to be in order to be called “full, 100° proof”)
(Lecture 21, Slide 7)

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14
Q

Why is 57.1% alcohol 100° proof?

A

As this is the weakest dilution of an alcoholic drink which would still allow gunpowder to be ignited when the two are mixed together
(Lecture 21, Slide 7)

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15
Q

Where is alcohol mainly distributed in the body?

A

In body water
(Lecture 21, Slide 9)

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16
Q

Where is alcohol rapidly absorbed into the bloodstream from?

A

The stomach and the intestines
(Lecture 21, Slide 9)

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17
Q

What can slow the absorption of alcohol 3-fold?

A

Fatty foods (such as milk)
(Lecture 21, Slide 9)

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18
Q

What speeds up absorption of alcohol?

A

Carbonation (a solution of carbon dioxide in water e.g champagne)
(Lecture 21, Slide 9)

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19
Q

Where does alcohol first travel to from the gut?

A

The liver
(Lecture 21, Slide 9)

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20
Q

When is peak alcohol concentration in the blood?

A

About 30-45 minutes after taking a drink
(Lecture 21, Slide 9)

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21
Q

How is ethanol converted to acetic acid?

A

Ethanol > Acetaldehyde > Acetic acid
(Lecture 21, Slide 10)

22
Q

Where is ethanol converted to acetic acid?

A

The liver
(Lecture 21, Slide 10)

23
Q

What converts ethanol to acetaldehyde and acetic acid?

A

Alcohol dehydrogenase breaks down ethanol to acetaldehyde and aldehyde dehydrogenase breaks down acetaldehyde to acetic acid
(Lecture 21, Slide 10)

24
Q

The build up of ______ is responsible for facial flushing and nausea?

A

Acetaldehyde
(Lecture 21, Slide 10)

25
Q

What does disulfiram inhibit and what does this result in?

A

It inhibits aldehyde dehydrogenase, resulting in a toxic build up of acetaldehyde
(Lecture 21, Slide 11)

26
Q

What is the medical use of disulfiram?

A

Used for aversion therapy to prevent alcoholics from relapsing
(Lecture 21, Slide 11)

27
Q

Which enzymes metabolise methanol to formaldehyde and then to formic acid?

A

Alcohol dehydrogenase converts methanol to formaldehyde and aldehyde dehydrogenase converts formaldehyde to formic acid
(Lecture 21, Slides 13 and 14)

28
Q

Which is more toxic; methanol or ethanol?

A

Methanol
(Lecture 21, Slide 13)

29
Q

What is the antidote for methanol and why does it work?

A

Large quantities of ethanol to compete for metabolism by liver enzymes, which allows the methanol to be excreted by other routes
(Lecture 21, Slide 13)

30
Q

Where is a small percentage of alcohol excreted in an unmetabolized form?

A

The breath and urine
(Lecture 21, Slide 15)

31
Q

What is the concentration of alcohol in the breath used to estimate?

A

The blood alcohol concentration (BAC) - hence a breath test
(Lecture 21, Slide 15)

32
Q

What is auto-brewery syndrome?

A

A rare condition in individual where yeast in their gut turns carbohydrate food into alcohol, which may cause them to become intoxicated
(Lecture 21, Slide 15)

33
Q

What is the rate-limiter for metabolising alcohol?

A

Alcohol dehydrogenase
(Lecture 21, Slide 16)

34
Q

What is the rate at which an average person metabolises alcohol?

A

Approx. 1 unit per hour
(Lecture 21, Slide 16)

35
Q

Why is blood alcohol concentration for a given drink higher in women than men?

A

As body water in men makes up a higher percentage of their body weight and women have less alcohol dehydrogenase
(Lecture 21, Slide 16)

36
Q

Name 3 adverse effects of chronic alcohol consumption.

A

Damage to almost every body system
Liver disease
Fetal alcohol syndrome
Several types of cancer
Reduced testosterone levels in men
Effects sperm production in men
Neurological degeneration (e.g dementia)
Effects cardiovascular system (though a small amount of alcohol per day may be cardioprotective)
(Lecture 21, Slides 18 and 19)

37
Q

Name 2 acute effects of alcohol on the brain

A

Depresses central nervous system
Depression of all neuronal activity
Affects processes modified by learning
(Lecture 21, Slide 20)

38
Q

What are the 3 main theories on the mechanism of action of alcohol?

A
  1. Enhancement of GABA acting on GABA A receptors
  2. Inhibition of calcium entry through voltage gated calcium channels and other calcium permeable ion channels, leading to reduced transmitter release
  3. Inhibition of glutamate receptor function
    (Lecture 21, Slide 21)
39
Q

Which neurones does ethanol increase the activity of?

A

Mesolimbic dopamine neurones
(Lecture 21, Slide 21)

40
Q

What is the tolerance of alcohol?

A

Behaviourally augmented tolerance
(Lecture 21, Slide 23)

41
Q

What 2 changes does tolerance of alcohol lead to?

A

Some ability to metabolise ethanol easier (enzyme induction)
Adaption of neurones
(Lecture 21, Slide 23)

42
Q

What does alcohol have a cross-tolerance with?

A

Barbiturates
(Lecture 21, Slide 23)

43
Q

What are 3 signs of ethanol dependence?

A

Ability to drink more without getting drunk
Irritability in the morning relieved by drink
Increasing memory lapses
(Lecture 21, Slide 24)

44
Q

Name 2 onsets at 8 hours of ethanol withdrawal.

A

Tremors
Nausea
Sweating
Fever
Possibly hallucinations
(Lecture 21, Slide 24)

45
Q

What 2 things happen after later on during ethanol withdrawal?

A

Convulsions are possible
Delirium tremens (confusion and aggression, more severe hallucinations)
(Lecture 21, Slide 24)

46
Q

Which drug helps reduce the withdrawal excitability of ethanol?

A

Long acting benzodiazepines
(Lecture 21, Slide 25)

47
Q

Which drug appears to help maintain abstinence of alcohol?

A

Acamprosate
(Lecture 21, Slide 25)

48
Q

What is the non-pharmacological solution to alcoholism?

A

Counselling and self-help groups
(Lecture 21, Slide 26)

49
Q

What is the drink-drive limit in scotland?

A

50 mg per 100 ml of blood
(Lecture 21, Slide 28)

50
Q

At what blood alcohol concentration does driving skill start to deteriate?

A

20 mg per 100 ml of blood
(Lecture 21, Slide 28)

51
Q

What effect does age have on the likelihood to drink drive and an accident occurring because of drink driving?

A

Young people are less likely to drink drive, but more likely to have an accident if they do
(Lecture 21, Slide 30)

52
Q

What effect does gender have on the likelihood of having an accident when drink driving?

A

Males with high blood alcohol concentration are more likely to be involved in a fatal crash, but females are more likely to have accidents
(Lecture 21, Slide 30)

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