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Flashcards in Alcohol 1 Deck (36)
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Current Drinker

Have had one drink in the past 30 days


Binge Use

Have had 5 or more drinks in the past 30 days


Heavy Use

Have had 5 or more drinks on 5 or more occasions in the past 30 days


Drinks with the same alcoholic content

All at .6 oz of alcohol
Beer- 12 oz
Malt Beer- 8 oz
Table Wine- 5 oz
Fortified Wine- 3.5 oz
Cordial Liquer- 2.5 oz
Brandy- 1.5 oz
80 Proof Shot- 1.5 oz



Rapidly absorbed via the GI tract
Subjected effects detected quickly- some may be due to expectancy
Plasma ethanol levels of 20 mg/dl can be detected
Placebo use due to olfactory and taste factors



Stomach serves as holding area- contains 20% of ethanol
92-94 % of ethanol absorbed metabolized and excreted
Remaining is directly excreted through sweat, tears, and breath


Racial Differences

Asian populations have low levels of alcohol dehydrogenase - increased flushing and greater levels of intoxication
Due to genetic variation between ethnicities


Enzyme Location

80-90% of alcohol dehydrogenase in the liver
Both enzymes are polypeptides, and are genetically controlled



Direct excretion through the breath is basis of breathalyzer
Ethanol concentration is in equilibrium between blood and tissues
Alveolar sacs are right next to capillaries
Values parallel the blood, except are artificially higher directly after drinking


Factors that speed absorption

- Carbonation- Speeds gastric emptying rate
-Aspirin- irritates gastric walls and causes faster gastric emptying rate
- Empty stomach- causes alcohol to go straight to small intestine


Factors that slow absorption

Food- slows gastric emptying rate
Water- Dilutes concentration
Marihuana- slows GI motility


Male/ Female Differences

Females have higher BAL with same amount of alcohol
Males typically have a higher muscle to fat ratio- alcohol is more diluted
Females with a higher fat ratio than males- alcohol not fat soluble, so it is concentrated in plasma
Females have 50% less gastric alcohol dehydrogenase than males


Theories on Mechanism of Action

Lipid Theory- Alcohol perturbates cellular membranes at the CNS
Protein Theory- Alcohol interacts with a neuronal protein site, neurotransmitter ion gates
Alcohol has some effect on protein function


Alcohol Sensitive Neurotransmitters

Nicotinic Acetylcholinergic



Major inhibitory neurotransmitter
Stimulation results in dampening of the signal
Receptor of several complex proteins
Activity of protein kinase C controls GABAa sensitivity to alcohol
Binding to GABA causes Cl ions to flow into the cell- ethanol enhances this
As a result, reduced anxiety and reduced motor coordination
Another binding site of these receptors for benzodiazepines



Major excitatory transmitter
Accounts for 40% of transmitters
NMDA subtype
Involved with learning and memory
May be involved in physical dependence
Normally allows Ca2+ to flow into the cell
Ethanol dampens Ca2+ flow into the cell by inhibiting NMDA like glutamate receptors


CNS and Physiological Effects

Euphoria- sense of well being, greater self esteem, feelings of confidence, increased talking and social ability

Varied effects on heart rate and blood pressure
Increased skin temperature due to vasodilation


Rate of Consumption vs BAC

Higher BAC with increased rates of consumption



Alcohol Dehydrogenase in liver- first line in breaking alcohol down- rate limiting step
Individual variations in rate, but falls within a predictable range of between 12-20 mg/dL/hr
Remains constant within an individual
Alcohol --> Acetaldehyde --> Acetate



Generally toxic to tissues in the body- irritant to skin and carcinogen
Causes a number of negative signs and symptoms- nausea, vomiting, facial flushing, headache, heart palpitations
Major contributor to hangovers
Buildup causes Alcohol Flush Reactions


Aldehyde Dehydrogenase

- Acetic acid is less toxic to the body
-Polymorphic variants on the genes that encode ALDH that alter the kinetic profile
- Mutant form of ALDH genes causes low levels of enzyme that results in high amounts of flushing and intoxication



Small amount on occasional basis



Binge drink occasionally, but stay sober for the most part


France drinkers

Consume large amounts of alcohol over a long time period


Chronic Alcoholic drinking pattern

Drink heavily for a few days, and then go on a self imposed sober period for 2-3 days. Then repeat this cycle


Functional Tolerance

NMDA receptors allow for Ca2+ to flow into the cell
Ethanol dampens NMDA stimulated Ca2+ flow
Tolerance develops at different rates to different effects- more quickly to mental functions, less quickly to motor control
Brain compensates by up-regulating and decreasing sensitivity at these receptors
Rapid tolerance to unpleasant effects of alcohol increase alcohol consumption


Reverse Tolerance

Increased sensitivity to alcohol after major liver damage


Metabolic Tolerance

Resistance to alcohols effects by increasing the enzymes that break alcohol down
Increased rate in breaking alcohol down


Behavioral Tolerance

Resistance to alcohol's effects that develops with repeated experiences of intoxication
Learned associations
Behaviors learned when intoxicated are better performed later when equally intoxicated


Physical Dependence

Results in hyper excitability during withdrawal period
8-12 hours after last drink
Begin: Mild agitation, nausea, vomiting, sweating, tremors, irregular heart rate
Hallucinations, clouded senses, seizures and delirium follow
Acute phase can last 7-10 days
Delirium tremens characterized with profound disorientation, perception disorders, severe tremors, restlessness and hallucination
Rare now with improved treatment of benzodiazepines, but death is possible