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Flashcards in Alcohol Deck (17):
0

Describe the distribution of alcohol

Distributes to all aqueous spaces
Absorption is slowed by food
Women exhibit higher peak blood alcohol conc than men
As they have lower body water and lower gastric alcohol metabolism

1

Where is alcohol excreted?

10% excreted by lungs and urine
90% oxidised in lover by alcohol dehydrogenase and microsomal ethanol oxidation system

2

Metabolism of alcohol at low concentration

Alcohol to acetaldehyde by alcohol dehydrogenase
(This also converts nad+ to nadh)
Acetaldehyde to acetate by aldehyde dehydrogenase
(Nad+ to nadh)

3

What is alcohol dehydrogenase and where is it found?

Cytosolic zinc containing protein found in lover and brain

4

Alcohol metabolism at high concentrations

Microsomal ethanol oxidising system (induced by chronic alcohol consumption)
Converts nadp+ to nadph
And alcohol to acetaldehyde

Acetaldehyde to acetate by aldehdye dehydrogenase
And nad+ to nadh

5

What does acetaldehyde cause?

Nausea, facial flusing, dizziness and headache

6

What does disulfiram cause?
Which also happens in some asians.

Inhibits aldehyde dehydrogenase
Therefore more acetaldehyde accumulates

Disulfiram was used for drug additcs, but didnt work.

7

What does excess nadh cause?

Alters liver function probably in the basis of liver toxicity

8

What is foetal alcohol syndrome

The foetus cannot metabolise alcohol
Mothers who drink alcohol leads to loss of neurones in animal models
Characteristic facial abnormalies (train track ears, folds on inside of eye, smooth philtrum
There is no safe level

9

How does ethanol make you drunk?

Not sure?
Drug is weak and dirty
No specific receptor identified
Delta subunit of gaba r
Inhibition of nmda r
Inhibition of n type calcium channels

Main response is inhibition a depressant

Also causes endogenous opiate release, activation of mu and delta opiod receptors

10

What are the mechanisms underlying chronic tolerance?

Increase in number and activity of enzymes that metabolise ethanol
Long lasting changes in the abundance and function of receptors

11

Mechanisms of acute alcohol tolerance?

Changes in function of nmda and gaba r
Nystagmus

12

What is himmelsbach hypothesis?

Withdrawl is what happens when alcohol mediated adaptions function in absence of alcohol
Ie. symptoms of withdrawl are opposite to effects of drug

13

Symptoms of withdrawl?

Arises due to abrupt cessation after chronic use
Motor agitation, anxiety, insomnia and reduction in seizure threshold
Delirium tremens (hallucinations, tremor, hyperpyrexia, sympathetic hyperactivity, death)

14

Treatment for withdrawl?

Hair of the dog? Works due to himmelsbach hypothesis
Benzodiazepines most commonly used in rehab to detox, but v dangerous if taken with alcohol

15

Chronic effects of alcoholism

Wernicke korsakoff syndrome
Caused by thiamine deficiency due to vitB1
Confusion, loss of motorcoordination, vision changes, memory loss, confabulation, hallucinations

16

Treatments for alcoholism?

DISULFIRAM deterent, doesnt work well
NALTREXONE opiod r antagonist, doesnt wory
ACAMPROSTATE nmda receptor antagonist, doesnt work
BEHAVIOURAL THERAPY doesnt work

COMBINATION OF THE ABOVE WORKS SLIGHTLY BETTER