Chapter 9 - Alcohol

Question 1

What is the only alcohol fit for human consumption?

Answer 1

ethyl alcohol (ethanol)

Question 2

Both ____ and ____ are commonly encountered but are completely unsafe to drink

Answer 2

isopropyl and methyl alcohol (or methanol)

Question 3

percentage of alcohol (or alcohol by volume) refers to…

Answer 3

the amount of alcohol in grams per 100 ml of solution
-proof of alcohol is twice the number of the percentage

Question 4

how much is one standard drink?

Answer 4

14 grams of 100% alcohol
-1.5oz of 50% alcohol
-5oz of wine
-12oz of beer

Question 5

alcohol is produced by ____, which is ____

Answer 5

fermentation; the product of yeast consuming starches and sugars in grains or fruits
-upper limit of % produced is about 15%
-wine 12-15%, beer 5%

Question 6

What is distillation?

Answer 6

process that increases the percentage of alcohol in a solution by heating then condensing vapour
-used to make drinks with much higher alc concentrations (rum, vodka, etc)

Question 7

History of alcohol

Answer 7

fermented since at least 6000 BC (mentions of wine in the bible); used by Greeks for medicine and recreation; pubs appeared in England by the 12th century

Question 8

pharmacokinetics of alcohol

Answer 8

ethanol is water and lipid soluble so it is easily absorbed; enters via GI tract; quicker absorption on an empty stomach and thru carbonated drinks

Question 9

Alcohol impairs which transporter in the upper GI?

Answer 9

thiamine (B1); can create deficiencies on body and brain

Question 10

What is Blood-Alcohol Concentration (BAC)?

Answer 10

grams of alcohol per 100ml of blood; BAC = 0.04 is produced by about two drinks; max BAC occurs after 45mins; used for legal definitions of intoxication

Question 11

metabolizing alcohol

Answer 11

occurs in stomach and liver; converted by alcohol dehydrogenase; some is metabolized by the P450 enzyme (CYP2E1)

Question 12

alcohol dehydrogenase 1C*1 allele polymorphism

Answer 12

increased alcohol dehydrogenase; alcohol converted to acetaldehyde more quickly; greater accumulation of acetaldehyde

Question 13

acetaldehyde H2*2 allele polymorphism

Answer 13

less aldehyde dehydrogenase; slower breakdown of acetaldehyde; greater accumulation of acetaldehyde (e.g., flushing of face)
-~1/2 of people of Asian descent

Question 14

elimination of alcohol follows ____

Answer 14

zero order kinetics; on average about 7g of alcohol per half hour (half a standard drink)

Question 15

breathalyzer tests use what to determine BAC?

Answer 15

Ratio of alcohol concentration in expelled air to blood is 1:2,300
- 0.11 breathalyzer = 0.11 BAC

Question 16

alcohol and GABAA receptors

Answer 16

positive modulator for ionotropic GABAA receptors; Cl- ions enter the neuron, hyperpolarize the cell, which inhibits neural activity; Increases the length of receptor activation and increases the flow of Cl- into the neuron

Question 17

depressant effects of alcohol are due to the receptors in ____

Answer 17

Cerebral cortex, hippocampus, and thalamus
–responsible for the depressant effects on
cognition/memory

Question 18

rewarding effects of alcohol are due to the receptors in ____

Answer 18

Nucleus accumbens and ventral tegmental area
– responsible for increased dopamine associated with reward

Question 19

alcohol and reward pathway

Answer 19

1. Alcohol facilitates GABAA receptors on GABA neurons in NA (that project to VTA) – leading to release of DA (disinhibition)
2. Alcohol activates GABAA receptors located on GABA neurons in the VTA which normally inhibit DA release (disinhibition)
3. Alcohol indirectly inhibits GABA neurons by increasing levels of β-endorphin

Question 20

chronic use of alcohol leads to…

Answer 20

1. Reduced number of GABAA receptors
   2.Reduced response of GABAA receptors to alcohol
   3.Less release of β-endorphin, resulting in less inhibition of GABA neurons

Question 21

alcohol and glutamate receptors

Answer 21

Alcohol inhibits NMDA glutamate receptors (binds to inside of ion channel, non-competitive antagonist); chronic administration leads to increased number of NMDA receptors
-during withdrawal: increased NMDA receptors = more excitation (by glutamate) coupled with lower GABAA receptor levels; increases risk of seizures

Question 22

alcohol and calcium

Answer 22

Alcohol inhibits L-type calcium channels: important for calcium influx at nerve terminals and NT release; suppresses release of vasopressin (ADH) in hypothalamus (alcohol leads to increased urination)

Question 23

alcohol and other NTs - serotonin

Answer 23

increases serotonin levels in the nucleus
accumbens by interacting with the ionotropic 5-HT3 and metabotropic 5-HT2A receptors.
– Note: Blocking these 5-HT receptors in NA, blocks rewarding effects of alcohol

Question 24

alcohol and other NTs - endocannabinoid system

Answer 24

May be part of reward circuit for alcohol.
– Similar to 5-HT, blocking cannabinoid
receptors in NA blocks release of DA in response to alcohol

Question 25

pharmacological effects

Answer 25

generally a depressant on behaviour and cognitive functioning; mood changes (euphoria, reduced anxieties, reduced inhibitions); ballance/equillibrium effected at low dose

Question 26

alcohol priming

Answer 26

refers to the tendency for individuals to feel an urge to drink more alcohol after having one of two drinks

Question 27

tension reduction hypothesis

Answer 27

suggests that habitual users of alcohol use it to reduce stress

Question 28

2 possible effects of alcohol

Answer 28

1. Alcohol stupor (or drunken stupor) can occur at BACs of 0.20 or higher. 2. Reversible drug-induced dementia occurs at BACs of 0.25 and higher and is associated with blackout (blackouts involve complete lack of memory for a period of alcohol intoxication) -at higher BACs, individuals tend to become unconscious -BACs of 0.25 or higher can cause alcohol poisoning

Question 29

4 dangers of chronic consumption

Answer 29

1. alcoholic cardiomyopathy 2. cirrhosis (liver) 3. fetal alcohol syndrome 4. Wernicke-Korsakoff’s syndrome

Question 30

what is fetal alcohol syndrome

Answer 30

facial and developmental abnormalities associated with mother’s alcohol use during pregnancy (peak BAC and duration of alcohol exposure) -prevalence: 0.2–1.5 per 1,000 births -increased risk of spontaneous abortion

Question 31

Acute tolerance

Answer 31

refers to tolerance that onsets during a given drug taking session

Question 32

Metabolic tolerance

Answer 32

involves an increase in liver enzymes that metabolize alcohol

Question 33

Pharmacodynamic tolerance

Answer 33

occurs as NMDA receptors are upregulated to offset the inhibitory effects of alcohol

Question 34

Behavioural tolerance

Answer 34

refers to reduced behavioral impairment observed in experienced drinkers

Question 35

Type I Alcohol Addiction

Answer 35

typically occurs in older individuals who are at high psychosocial risk for addiction

Question 36

Type II Alcohol Addiction

Answer 36

typically occurs in younger individuals who are at a high genetic risk for addiction

Question 37

Abstinence syndrome

Answer 37

medically more severe and more deadly than opioid withdrawal; if untreated, mortality can be as high as 1 in 7; detoxification should be carried out in an inpatient medical setting

Question 38

4 stages of alcohol withdrawal

Answer 38

Stage 1: tremors, rapid heartbeat, hypertension, heavy sweating, loss of appetite, insomnia Stage 2: hallucinations (auditory, visual, and/or tactile) Stage 3: delusions, disorientation, delirium Stage 4: seizures

Question 39

Cognitive Behavioural Therapy (treating alcohol addiction)

Answer 39

aim to improve cognitive and behavioral skills to change problematic patterns of alcohol use

Question 40

Pharmacotherapy (treating alcohol addiction)

Answer 40

Disulfiram (Antabuse): used to make drinking less likely by creating aversive effects following alcohol consumption. Naltrexone: opioid antagonist that may block reinforcing properties of alcohol. Acamprosate (Campral): FDA approved for the treatment of alcohol addiction; thought to reduce cravings for alcohol by affecting calcium channels to reduce activity of NMDA receptors