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PYB260 > W 8 - Alcohol > Flashcards

W 8 - Alcohol Flashcards

1
Q

What are the three forms of alcohol?

A
  • Isopropyl
  • Methanol
  • Ethanol (drinking alcohol)
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2
Q

What is the fermentation process?

A
  • Sugar dissolved in water
  • Yeasts multiply and convert sugar into ethanol and CO2
  • Alcohol content about 10 - 15 %
  • Fermented wines = extra alcohol
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3
Q

What is the distillation process?

A
  • Fermentation –> Heated –> alcohol given off in vapor –> vapor cooled
  • Alcohol content - 40 - 50%
    Brandy = distilled wine
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4
Q

What is the main mode of administration?

A
  • Oral
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5
Q

What is the absorption of alcohol like?

A
  • Molecules cannot be ionized - pH levels have no effects upon absorption
  • Readily dissolved in water & passes into blood from stomach lining, intenstines & colon
  • 1st pass metabolism - alcohol dehydrogenase in stomach
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6
Q

What is the absorption rate and BAL affected by?

A
  • Stomach contents
  • Body fat (higher body fat means less water to dilute alcohol so greater concentrations)
  • Medication
  • Female sex (decrease in alcohol dehydrogenase, more body fat)
  • alcohol concentration
  • age
  • usage (abstainers vs regular)
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7
Q

When the the BAL generally at a plateau

A

approx 1 hr after consumption

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8
Q

When is peak BAL?

A

approx 15 min after consumption (but depends when readings are take - after a few drinks levels reached sooner)

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9
Q

What drink types effect absorption

A

o Beer stays in stomach longer
o Absorption sparkling wines facilitated by carbination
o Higher concentration absorbed more quickly, up to a point ([~ 40 % alc.])

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10
Q

What is the expectance effect

A

Those who expect alcohol may have greater concentrations

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11
Q

What is the theoretical time course for BAL after single drink?

A
  • A = Absorption Phase
  • B & C = Plateau Phase
  • D = Excretion Phase
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12
Q

What is the distribution of alcohol in body?

A
  • Alcohol dissolves in water – distributed entirely in body water
  • Crosses blood-brain barrier and placental barrier
  • Circulates through lungs and vaporises in air (Breathalizer)
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13
Q

Where is alcohol excreted?

A

 Some alcohol is excreted through breath,
sweat & urine
 Most alcohol is metabolized in the liver (~90-98%)
– at rate ~ 1 SD/hr

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14
Q

How is alcohol metabolised by the liver?

A
  1. Alcohol is converted to acetaldehyde by alcohol dehydrogenase
  2. Acetaldehyde is converted into acetyl-coenzyme A
    Acetyl-coenzyme A is then converted to water & CO2, via the Krebs cycle (or “citric acid cycle”)
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15
Q

What does having a genetic polymorphism in the kreb’s cycle mean?

A

Genetic polymorphism means they can’t break down acetaldehyde – can’t break down so often a protective factor

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16
Q

How does excretion vary between individuals?

A
  • Excretion varies greatly between individuals

o Typical range ~ 10-20 mg/100ml/hr

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17
Q

What may affect the metabolism of alcohol?

A
  • Rate of metabolism may depend on drinking experience
    o Non-drinkers metabolize alcohol slightly slower
  • Eating speeds metabolism of alcohol – increases blood supply to the liver to speed up
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18
Q

What is the excretion of methanol and what are the effects of ingesting it?

A
  • Excretion of methanol:
    o Formaldehyde and formic acid
    o Blindness and death if ingest methanol because of metabolites that lead to effects
    o Ethanol treats methanol poisoning
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19
Q

What is the Microsomal ethanol-oxidizing system (MEOS)?

A
  • Also responsible for metabolism of alcohol
  • Increased activity with continuous drinking – thus heavy drinkers metabolize alcohol more quickly → metabolic tolerance
    o Up regulation of MEOS system causes tolerance
  • Also responsible for metabolizing barbiturates → cross tolerance
    o Used to be used similar the benzodiazepam
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20
Q

What are the interesting neuropharmacological traits of alcohol and what does this mean about alcohols site of action?

A
  1. Alcohol affects a variety of tissues
  2. Need a large dose to have an effect
  3. No drugs act as complete antagonists to all of the effects of alcohol
    Therefore – conclude that alcohol does not work directly on specific receptor sites, but affects many sites of action
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21
Q

What is GABAA?

A

Inhibitory NT - GABBA-receptor-ionophor complex

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22
Q

Where are the sites of action of GABBA-receptor-ionophor complex?

A

 Orthosteric & allosteric sites *– alcohol ¬ GABA effects (¯ neural activity) \ alcohol acts as a positive allosteric modulator
 e.g. effects on cerebellum → inhibits pikinge neurons – causes stumbling and coordination

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23
Q

Where are the GABAB (metabotropic) receptors and what do they do?

A

May induce release of DA
-  e.g., in VTA → less inhibition of DA release into NAcc
 Inhibition of inhibition

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24
Q

How does alcohol affect 5-HT?

A

 Alcohol stimulates 5-HT3 receptor (also important in releasing DA)

25
Q

Where does ethanol bind and what does this mean?

A
  • Ethanol binds to allosteric binding site – affects the ability to open ion channel
  • Positive allosteric moderator because helps GABA ion channel to open – chloride flows in which hyperpolarizing it and inhibiting action potential
26
Q

What is glutamate

A

an excitatory NT

27
Q

How does alcohol effect Glutamate?

A
  • Alcohol decreases functioning at NMDA receptor (blocks ion channel)
28
Q

What does chronic exposure to acholol cause in terms of ion channels

A

Up-regulation of NMDA and glutamate
o Contributes to withdrawal effects of alcohol
- Hippocampus (NDMA receptors) and
o Memory consolidation – accounts for alcohols effect on memory
- PFC (glutamate and GABA neurons) – inhibits the brain and especially prefrontal cortex which leads to disinhibition – may say or do things wouldn’t otherwise do

29
Q

What other things does alcohol effect?

A
  • Second messengers
  • Monoamine oxidase
  • Glycine
  • Acetylcholine
  • Endogenous Opiod Systems
30
Q

What are alcohol’s effects on the body?

A

Dilation of blood vessels - flushing (but decreased body temp)
- Increased urination

31
Q

What are alcohol’s effects on sleep?

A
  • Induces sleep, but does not increase total sleep time
  • Decreased REM (1st part of sleep at low doses, whole night at higher doses, tolerance ~ 3 days)
    o Important for memory consolidation
  • REM rebound effects upon cessation
  • Body develops tolerance to alcohols effects on REM quickly because body needs it
32
Q

What is alcohol’s effect on perception?

A
  • At high doses, decreased absolute and difference thresholds for vision
  • Decreased visual acuity (~0.7 BAC)
  • Lowered peripheral vision
  • Decreased sensitivity to smell, taste and pain (~0.07 – 0.08 BAC)
33
Q

What are the subjective effects of alcohol?

A
  • Biphasic effect re time and dose – but not for everyone

- Stimulant-like effects may ~ greater risk of abuse

34
Q

What are alcohol’s effects on performance?

A
  • Increased (slowed) reaction time
  • Decreased hand-eye coordination (cerebellum)
  • Decreased speed and accuracy
  • Decreased vigilance
  • Decreased memory (storage and retrieval)
    o En bloc blackout
    o Grayout
  • Decreased sensitivity of organs in the inner ear responsible for balance (Romberg sway test for drink driving)
35
Q

What are alcohol’s effects on behaviour?

A
  • Disinhibition
  • Talkative, excitable, cheerful
  • Sleepy, unconscious
  • Nausea, vomiting
36
Q

What are alcohol’s effects on driving?

A
  • Impairs driving performance ~ 0.05 – 0.08 (lower for many)
  • Reflected in crash statistics – young people overrepresented in drink driving fatalities
37
Q

What are the conditioned responses to alcohol?

A
  • Reinforcing properties of alcohol are dose dependent
  • Decreased shock avoidance
  • Increased response rates that have been paired with shock
  • Similar effects in humans – alcohol decreases effect of aversive stimuli
38
Q

What are the discriminative properties of alcohol?

A
  • Easy discrimination from saline
  • Generalized to barbiturates
  • Can be blocked by 5-HT3 receptor blockers and opioid receptor blocker (nalterexone) but not a dopamine D2 blocker
39
Q

What is the self-administration tendency in animals?

A
  • Rats will drink in small doses, unless forced consumption
  • Deprived of food and water/or paired associations
  • Generally, rats will self administer sporadically, with periods of abstinence
40
Q

What is the self-administration in humans?

A
  • Usually high consumption followed by abstinence
  • Depends on:
    o Culture
    o Gender
    o Age
    o Availability
41
Q

What is the acute and selective tolerance of alcohol?

A
  • Occur while still drinking – esp. to the subjective feeling of intoxication
42
Q

What is the chronic tolerance to alcohol?

A
  • Develops very quickly, within weeks for humans

- Does not develop equally for all effects

43
Q

What is the metabolic tolerance of alcohol?

A
  • Stimulation of alcohol dehydrogenase and MEOS
44
Q

What is the conditioned tolerance for alcohol?

A
  • Hypothermic Effects

- Environmental Tolerance

45
Q

What is Early Minor Syndrome?

A
  • Can occur whilst still drinking but usually within 8-12 hours
  • Agitation, tremors, muscle cramps, vomiting, nausea, sweating, dreams etc
  • Usually over < 48 hours
46
Q

What is Later Major Syndrole

A

Delirium tremors (DTs)

  • 2 days of minor symptoms followed by disorientation, confusion, hallucinations & seizures
  • Lasts 7-10 days
  • Can cause death if not managed (usually with anxiolytics &/or antipsychotics)
47
Q

What is the therapeutic index of alcohol?

A

Low - 3.3

48
Q

What is alcohol poisoning?

A

 .3 - .4 = unconsciousness

 .5 = death from respiratory failure <1-2 hours

49
Q

What are the dangers to do with hangovers?

A

Dangerous with epilepsy, heart disease or diabetes

50
Q

What are the socio-cultural harmful effects of alcohol?

A
  • Accidents
  • Relationships
  • Finances
  • Criminal Behaviour
51
Q

What are the acute harmful effects on reproduction?

A

Small doses - inhibition

Large doses - sexual arousal

52
Q

What is the chronic harmful effects on reproduction?

A

 Loss of interest in sex
 Impotence; shrinking testes
 Menstrual dysfunction
 Spontaneous abortion

53
Q

What is foetal alcohol syndrome?

A

 Cognitive impairments, poor coordination, ¯ birth weight, facial characteristics, malformed organs

54
Q

What are the harmful effects on the liver?

A
  • Hepatitis
  • Cirrohosis
  • Immune functioning
55
Q

What are the harmful effects on the nervous system?

A

 Korsakoff’s syndrome – thyamine definiency – treatable through B1 injections
 Epilepsy
 Dementia
 Peripheral neuropathy

56
Q

What is the effect on cancer and what makes this worse?

A
  • Mouth, throat and liver cancer

- -> Even greater increased risk with smoking

57
Q

What are the effects on heart disease?

A
  • Alcoholic cardiomyopathy
58
Q

What are the pharmacotherapies for alcohol dependence?

A 
	Disulfiram (Antabuse)
	blocks aldehyde dehydrogenase
	Acamprosate (Campral)
	¯ glutamate activity
	Naltrexone
	Opioid receptor antagonist

PYB260 (9 decks)

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