Alcohol

Question 1

How commonly abused is alcohol?

Answer 1

After caffeine, is the most commonly abused psychoactive drug and most abused drug in general

Question 2

What is mead and when was it created?

Answer 2

Fermented honey.

8000-10000 BC

Question 3

When and where was the first official brewery formed?

Answer 3

3700 BC in Egypt

Question 4

When did distillation first occur, and when was the process perfected?

Answer 4

Middle ages.

Perfected by the Dutch in 17th century

Question 5

How is alcohol made?

Answer 5

Ethyl alcohol created by fermentation (yeast metabolizes sugar)

Question 6

What is brewing beer?

Answer 6

Fermentation of starchy grains

Question 7

What does fermentation do?

Answer 7

Gives maximum of about 15% alcohol

Question 8

How soluble is alcohol?

Answer 8

It is a small molecule, so moderately soluble in fat and highly soluble in water

Question 9

Where is alcohol absorbed?

Answer 9

It is easily absorbed in the GI tract. 10% is absorbed into blood directly from stomach, and remainder absorbed in upper small intestine

Question 10

How much alcohol reaches brain immediately? Why?

Answer 10

90%.

Alcohol easily passes blood-brain barrier and placental barriers

Question 11

What is blood alcohol concentration? How can it be estimated?

Answer 11

Grams of OH/100mL of blood expressed as %.

Can be estimated from body weight, number of standard drinks consumed, and hours elapsed since starting to drink

Question 12

What is the LD50 of alcohol?

Answer 12

About 0.45

Question 13

How is alcohol eliminated?

Answer 13

5% is eliminated by lungs, and remainder is eliminated in urine after biotransformation to CO2 and H2O

Question 14

What is the body’s primary reaction to alcohol? How does this occur?

Answer 14

To metabolize it through oxidation. It is constant over time.

Question 15

What is the enzyme that metabolizes alcohol? What is alcohol metabolized to? Where does this occur?

Answer 15

Alcohol dehydrogenase forms acetaldehyde from alcohol.

It is found in the stomach, where 20% is broken down before absorption. The remainder is metabolized by the liver

Question 16

What happens to acetaldehyde?

Answer 16

Acetaldehyde dehydrogenase transforms acetaldehyde to acetic acid, which is oxidized to O2, CO2, and calories of energy.

Question 17

What happens when acetaldehyde dehydrogenase is less active? How is this related to genetics?

Answer 17

Flushing, headaches, nausea, increased HR.

10% of Asians are homozygous for inactive form of acetaldehyde dehydrogenase, and 40% are heterozygous.

Question 18

What type of drug is alcohol?

Answer 18

A CNS depressant of the sedative hypnotic class

Question 19

Why is alcohol misperceived as a stimulant?

Answer 19

Release of cerebral cortex inhibitory control over subcortical systems and impaired judgement/thinking from loosening of social inhibitions

Question 20

What are the specific actions of alcohol?

Answer 20

Acts at neurotransmitter binding site, modifies gating mechanism inside channel, interacts directly with channel protein, and stimulates Gs (linked to adenylyl cyclase)

Question 21

What are the nonspecific actions of alcohol?

Answer 21

Alters lipid composition, interacts with polar heads of phospholipids, and disturbs relationship of protein in the membrane

Question 22

What are some behavioural effects of alcohol?

Answer 22

Anti-anxiety, reduced social inhibition, reduced attention, impaired judgement/self-perception (increased risk-taking behaviours), memory deficits that are dose- and task-dependent, reduced motor coordination

Question 23

Does alcohol have a reinforcing effect?

Answer 23

Yes. Mesolimbic system is important in reinforcement and motivational mechanisms. Alcohol increases VTA firing, and rats will work to have alcohol administered to VTA

Question 24

What is the role of endogenous opioids (endorphins) in alcohol?

Answer 24

Endogenous opioids (endorphins) contribute to reinforcing properties of OH.
OH increases endorphin and enkephalin release in animals and humans.

Question 25

What are protective behaviours in alcohol consumption?

Answer 25

Vomiting and loss of consciousness

Question 26

What is Wernicke-Korsakoff syndrome?

Answer 26

AKA alcoholic dementia. Encephalopathy and psychosis, cognitive deficits, confusion, disorientation abnormal eye movements, motor difficulties, chronic amnesia, general apathy, and confabulation.

Question 27

What neurologic changes may result from chronic alcohol consumption?

Answer 27

Loss of neurons, enlargement of vesicles due to vitamin B1 (thiamine) deficiency which is necessary for neurons to use glucose (also B2, B6, C, niacin, folacin, Zn, Mg)

Question 28

What other systems are affected by alcoholism?

Answer 28

Liver disease (hepatitis, cirrhosis), cardiovascular problems, cancer (esophagus, pharynx, larynx, as smoking is a comorbidity), renal-urinary (reduced ADH), reproductive, GI

Question 29

What is fetal alcohol syndrome?

Answer 29

Extreme susceptibility of fetus to what is in the mother's bloodstream, as alcohol is teratogenic. Fetus has low acetaldehyde dehydrogenase, so not metabolism. Greatest risk occurs between 4-9 weeks. Deficits in short-term memory, problem solving, hyperactivity, growth retardation, CNS abnormalities, skull and facial appearance

Question 30

What is metabolic tolerance with alcohol?

Answer 30

Cytochrome P450 family metabolizes many substrates, including alcohol. When alcohol is consumed regularly, these enzymes increase, which increases the rate of metabolism.

Question 31

Describe acute alcohol tolerance.

Answer 31

Behavioural and neural adaptation

Question 32

Describe chronic alcohol tolerance.

Answer 32

Increased alcohol dehydrogenase, decreased neural responsiveness, and behavioural tolerance.

Question 33

How long does withdrawal syndrome last for alcohol, and what are the symptoms?

Answer 33

Withdrawal syndrome lasts from hours to days. | Tremor, anxiety, increased BP/HR, sweating, respiration, nausea, and vomiting

Question 34

Why is competition a factor in alcohol's interaction with other drugs?

Answer 34

Due to cytochrome P450 enzyme binding, when alcohol is taken with other drugs, it may lead to potentially dangerous levels of those drugs

Question 35

How does alcohol impact the glutamate system?

Answer 35

Alcohol reduces the effect of glutamate at NMDA receptors, reducing glutamate release. NMDARs are important for learning and memory, synaptic plasticity, and spatial memory. Chronic use leads up-regulation of NMDARs.

Question 36

How does post-alcohol withdrawal affect glutamate?

Answer 36

Post-alcohol withdrawal leads to increased glutamate release, which may result in excitotoxicity and neuronal cell death

Question 37

How does alcohol affect the GABA system?

Answer 37

Alcohol is a GABA agonist, so increases Cl influx. | Chronic use leads to decreased Cl flux, increased sensitivity to convulsants, and down-regulation of GABA-A receptors

Question 38

How do dopamine antagonists affect alcohol consumption?

Answer 38

Dopamine antagonists infused into NAcc shell reduce self-administration of alcohol

Question 39

How do opioid antagonists affect alcohol consumption?

Answer 39

Opioid receptor antagonists, such as naloxone, reduce alcohol use

Question 40

What is alcohol use disorder?

Answer 40

Caused by neurobiological, psychological, and sociocultural factors. Involves compulsive alcohol seeking and use despite damaging consequences

Question 41

How can alcohol use disorder be treated?

Answer 41

Individual needs to want to stop. Denial is prevalent. Detoxification occurs. Psychosocial rehabilitation prevents relapse.

Question 42

Which drugs can be used to treat alcohol use disorder?

Answer 42

Antabuse (inhibits acetaldehyde dehydrogenase), Naltrexone (inhibits opioid receptors), Acamprosate (NMDAR partial antagonist)