Alcohol Flashcards by Wasim Silmi

Why is it easier to understand dose of alcohol

Because its legal

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Safe level of alcohol consumption?

<14 units/week

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Where can Alcohol can be absorbed from ? % of absorption in each place?

Usually oral

- Alcohol can be absorbed from the stomach (20%) and the intestines (intestines designed for absorption) (80%)

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How does drinking on a full stomach influence your blood alcohol level?

Much more alcohol is absorbed in the small intestine- if you drink on a full stomach, gastric emptying is delayed, and alcohol is less effectively absorbed

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What % of alcohol is metabolised and where’s the rest of it

90% is metabolised- 10% doesn’t change at all, it’s just excreted, some of which is via the lungs and is what the breath test measures

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Where is alcohol metabolised? What % where?

85% liver

15% GIT (stomach):

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What enzymes metabolises alcohol

Alcohol dehydrogenase (metabolises 75%) and mixed function oxidase (25%) convert alcohol into acetaldehyde (this is toxic)

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What is the metabolite of alcohol

acetaldehyde

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what order kinetics of metabolism is alcohol

Zero order

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What does alcohol metabolism depend on

first pass hepatic metabolism and saturation of liver enzymes

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What causes tolerance to alcohol

upregulation of mixed function oxidase enzymes

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Difference between men and women re. alcohol dehydrogenase

Females have much less of this enzyme in their stomach compared to men

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Where can you find alcohol dehydrogenase

Stomach and liver

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Why can alcohol diffuse across lipid membranes

its tiny size, it can just squeeze through the gaps in the membrane.

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A man and a woman of similar height and weight share a bottle of wine. Explain why the blood alcohol levels in the woman are likely to be higher.

Because women metabolise it less effectively in stomach, they have 50% less alcohol dehydrogenase in the stomach wall than men so more alcohol enters the blood stream, and it is then less well diluted/distributed across body tissues (more concentrated so more potent effect)

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Acetaldehyde is broken down by….

aldehyde dehydrogenase

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Acetaldehyde is broken down into …

inert acetic acid (acetate)

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What is disulfiram

aldehyde dehydrogenase inhibitor

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An aldehyde dehydrogenase inhibitor?

Disulfiram

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use of aldehyde dehydrogenase inhibitor

alcohol aversion therapy

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Use of disulfiram

Alcohol aversion therapy

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Potency of alcohol?

Low

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Low potency of alcohol means what regarding drug targets

Study These Flashcards

has a weak effect on a lot of targets (low potency)

What makes the potency of alcohol low

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Weak affinity and low efficacy

Why are alcohol ACUTE EFFECTS DIFFICULT TO FIGURE OUT

CNS IS COMPLEX AND ETHANOL HAS LOW POTENCY + SELECTIVITY (because its so low in potency there is no specific target for alcohol)

Effect of alcohol on GABA

- Positive effect on GABA receptors: Directly effects the GABA receptor post-synaptically, causing increase in function Also evidence that it acts pre-synaptically to increase release of allopregnenolone which binds to GABA receptors to increase their effect

Effect of alcohol on NMDA receptors

- Decreases NMDA receptor activation- NMDA receptor = excitatory

Effect of alcohol on Ca channels

- Decreases Ca2+ channel opening and impacts neurotransmitter release in general

Euphoric effect of alcohol? Similar to what drug? What dose is needed

- At high dose can behave like heroine and morphine | - Binds to opioid receptor and switches off GABA inhibitory signal, increasing firing rate of dopaminergic neurones

Effect of alcohol on corpus callosum

Alcohol interferes with coordination of the sides of the brain

Effect of alcohol on HYPOTHALAMUS

Effects appetite, emotions etc.

Effect of alcohol on RETICULAR ACTIVATING SYSTEM

Alcohol impairs consciousness

Effect of alcohol on HIPPOCAMPUS

Alcohol impairs memory

Effect of alcohol on CEREBELLUM

Alcohol impairs coordination

Effect of alcohol on BASAL GANGLIA

Alcohol impairs time perception

Effect of alcohol on arterioles

Red face caused by increased acetaldehyde- interferes with smooth muscle function in the arterioles (vasodilation): - Impaired calcium entry - Increased prostaglandin release

Effect of alcohol on heart

Tachycardia, Due to depressant effect on baroreceptors- stops them from enhancing parasympathetic fucntion and inhibiting sympathetic function

Effect of alcohol on kidney

Diuresis Acetaldehyde inhibits production of ADH (vasopressin)- less aquaporins inserted into collecting duct- lose more fluid (polyuria)

How does alcohol cause dementia

Alcohol causes cortical atrophy and decreased volume of cerebral white matter, confusion (encephalopathy) and oculomotor symptoms

How does alcohol cause ataxia

Cerebellar cortex degeneration - gait

How does alcohol cause WERNICKE-KORSAKOFF SYNDROME

Due to thiamine deficiency- alcoholics have a very poor diet and carbohydrates are needed to get thiamine- without it you get acidosis, excessive glutamate production etc.- neurones don’t work

2 parts of WERNICKE-KORSAKOFF SYNDROME?

- WERNICKE’S ENCEPHALOPATHY and - KORSAKOFF’S PSYCHOSIS

Describe - WERNICKE’S ENCEPHALOPATHY

This part is reversible 3rd ventricle and aqueduct damaged Ataxia, eye problems, confusion

Describe - - KORSAKOFF’S PSYCHOSIS

This is irreversible Dorsomedial thalamus damaged Memory problems from hippocampus damage Confabulation, eventually death

What do you use to metabolise alcohol to acetaldehyde

NAD+

First things you see when someones been binge drinking? Why

After binging alcohol you lose ability to metabolise fats and lipids, a fatty liver containing lots of triacylglycerol is one of the first things you see when binge drinking alcohol. this is because NAD+ is needed for glycolysis, making Acetyl-CoA, Krebs cycle etc.

How does binge drinking cause liver acidosis/ketosis

Lack of NAD+ causes pyruvate to be converted to lactate and Acetyl-CoA to be converted to ketones

Alcohol acute liver effect?

Fatty liver

Alcohol chronic liver effect? (2) cause?

Liver inflammation and hepatitis from leaked free oxygen radicals

Where do leaked free radicals come from

Mixed function oxidase system overuse

Longer chronic effect of alcohol on liver? (2)

FIBROBLAST INFILTRATION & CIRRHOSIS

When does liver damage become irreversible (2)

AFTER FIBROBLAST INFILTRATION & CIRRHOSIS

Beneficial effects of low chronic use of alcohol (4)

- Decreased mortality from coronary artery disease (men 2-4 units/day) - Increased HDLs - Increased tPA levels and decreased platelet aggregation - Are polyphenols protective (found in red wine)?

ALCOHOL CHRONIC EFFECTS- GIT: (2)

- Damage to gastric mucosa due to toxic acetaldehyde (can lead to ulceration etc.) - Carcinogenic effect

ALCOHOL - CHRONIC EFFECTS- ENDOCRINE (2)

- Increased ACTH secretion (and cortisol production) | - Decreased testosterone production

Hangover headache caused by...

Vasodilation

Hangover nausea caused by...

Irritant, vagus, vomiting centre

Alcohol Flashcards

(57 cards)