Alcohol Flashcards

1
Q

How would you work out the absolute amount of alcohol consumed?

A

%ABV x 0.78

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2
Q

How many units is considered binge drinking in the uk?

A

> 8 units in one sitting

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3
Q

How much of alcohol is absorbed from what different parts of the body?

A

20% from the stomach directly

80% from the intestine

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4
Q

What is the speed of onset of intoxication proportional to?

A

Gastric emptying

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5
Q

Why does eating a meal decreases the speed of onset of alcohol?

A

Postprandial, the stomach does not empty often as it needs to break down food thus alcohol is not absorbed very well

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6
Q

How is alcohol metabolised?

A

90% is metabolised, 10% breathed off. 85% of metabolism occurs in the liver, 15% occurs in the GIT.
Liver metabolism: alcohol -> adetaldehyde (toxic) via 75% alcohol dehydrogenase and 25% mixed function oxidase.

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7
Q

Which type of enzyme is most significantly upregulated in chronic alcoholics?

A

Mixed function oxidase

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8
Q

Why does a shot of alcohol affect you more than the same amount of alcohol in 4 seperate doses

A

Because a single high dose alcohol bolus will saturate the enzymatic system

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9
Q

Why are women more susceptible to alcohol?

A

Men have a greater volume of body water and women have more adipose tissue, so the water allows alcohol to be more widely distributed in men so at a lower concentration -> men have more ADH as well so more able to metabolise

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10
Q

What is disulfiram and what is it used for? How does it work?

A

It is an inhibitor of aldehyde dehydrogenase - effective in alcohol aversion therapy as build up of acetaldehyde makes you feel sick and not want to drink alcohol

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11
Q

What is the potency of alcohol? Why?

A

Low
Influences a lot of receptors due to its uncomplicated shape however doesn’t fit a lot of the receptors very well so not a lot of efficacy

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12
Q

What effect does alcohol have on the CNS (mainly)

A

Depressant effect mainly - dependent upon environment and personality of the individual

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13
Q

How does alcohol depress the CNS system?

A

Increasing inhibition - pre and post synaptic

Reducing excitation - reducing stimulation at NMDA receptors and reducing Ca2+ influx so less NT exocytosis

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14
Q

Why is it difficult to assess the acute CNS effects of alcohol?

A

CNS is functionally complex

Ethanol has low potency therefore low selectivity

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15
Q

How does alcohol have euphoric effects on the CNS

A

Alcohol binds to the u receptor to inhibit GABA release - less inhib GABA so less inhib on DA release by the VTA DA neurones into the NAcc

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16
Q

What parts of the brain does alcohol affect?

A
  • Corpus callosum – information from leftàright.
  • Hypothalamus – controls appetite, emotions, pain, temperature.
  • RAS – consciousness.
  • Hippocampus – memory.
  • Cerebellum – movement & coordination.
  • Basal ganglia – perception of time.
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17
Q

What are the acute effects of alcohol on the CVS?

A

Vasodilation and increased HR

18
Q

What are the acute effects of alcohol on the endocrine system?

A

Diuresis (polyuria)

19
Q

How does alcohol cause vasodilation?

A

Cutaneous vasodilation - flushing by decreased Ca2+ influx so less VSM contraction leading to increased prostaglandins (vasodilators)

20
Q

How does alcohol increase heart rate?

A

Alcohol diminishes the control of the brain on the arterial baroreceptors and so the heart recieves less inhibitory input
-> SNS becomes dominant and heart rate increases

21
Q

How does alcohol cause diuresis (polyuria)

A

ADH (alcohol dehydrogenase) supresses VP release and less VP release leads to less water reabsorption causing diuresis

22
Q

What are chronic effects of alcohol on the CNS?

A

Dementia
Ataxia
Wernicke-korsakoff’s syndrome

23
Q

What happens to the brain in dementia?

A

Cortical atrophy and decreased cerebral white matter

24
Q

What happens to the brain in ataxia?

A

Cerebellar cortex degeneration

25
What happens to the brain in wernicke-korsakoff's syndrome?
Wernicke's encephalopathy - affects the 3rd ventricle and aqueduct REVERSIBLE Korsakoff's psychosis - affects the dorsomedial thalamus (impairs memory - they make memories up) IRREVERSIBLE
26
What is Wernicke-korsakoff's syndrome due to?
Due to thiamine deficiency (less food intake as calories from alcohol)
27
What are the chronic effects on the liver due to alcohol due to?
NAD+: NAD+ is needed for lots of functions, alcohol dominates the use of NAD+ and thus NAD+ is not used for the other functions leading to a build up of other dangerous toxic by-products
28
What are examples of chronic effects of alcohol on the liver?
Fatty liver Hepatitis Cirrhosis
29
What is fatty liver in alcohol toxicity due to?
Lack of NAD+ leading to TAGs deposited in the liver
30
What is hepatitis in alcohol toxicity due to?
Mixed function oxidases upregulated in chronic alcoholics leading to free radicals that generate an inflammatory response Cytokines are then released eg increased IL-6 and TNF alpha
31
What is cirrhosis in alcohol toxicity due to?
Fibroblasts lay down fibrin supportive structures that reduce regenerative capacity of liver - decreased regeneration and active liver tissue, increased fibroblasts
32
What are positive effects of alcohol on the CVS?
- decreased mortality from coronary heart disease - increased HDLs - increased tPA levels -> decreased platelet aggregation levels - polyphenols (red wine) may reduce free radicals
33
What are the chronic effects of alcohol to the GIT?
Damages gastric mucosa (in proportion to the dose) - can lead to stomach cancer from acetaldehyde build up - acetaldehyde is a carcinogenic
34
What are the chronic effects of alcohol on the endocrine?
Increased ACTH secretion -> cushing's like syndrome | Decreased testosterone -> gynecomastia
35
What are examples of symptoms as the blood alcohol concentration reaches 0
- nausea - headache - fatigue - restless and muscle tremours - polyuria, polydipsia
36
Why do you get nausea in a hangover?
Irritant -> vagus -> vomiting centre of medulla
37
Why do you get headaches in a hangover?
Vasodilation
38
Why do you get fatigues in hangover?
Sleep deprivation 'rebound'
39
Why do you get restlessness and muscle tremors in a hangover?
'rebound' excitation
40
What do you get polyuria and polydipsia in a hangover?
Decreased VP secretion