Flashcards in L05 Alcohol Deck (23):
How many calories per gram does ethyl alcohol have?
What percentage of the adult American population drinks regularly?
How does the DSM IV classify alcohol abuse?
The DSM IV considered alcohol abuse and alcohol dependence as separate disorders.
How does the DSM V classify alcohol abuse?
The DSM V combines alcohol abuse and alcohol dependence into a single designation, alcohol use disorder.
What percentage of the US population is affected by alcohol use disorder?
In a standard drink (12 oz beer, 5 oz wine, 1.5 oz spirit), how much alcohol is present?
A standard drink contains ~14 grams of alcohol.
Where is alcohol absorbed?
Alcohol is absorbed rapidly and extensively from the stomach via passive diffusion.
What affects the rate of alcohol absorption and intoxication?
The gastric state influences the rate of alcohol absorption and intoxication.
Describe the volume of distribution of alcohol.
Alcohol has a wide volume of distribution and easily penetrates the blood-brain barrier.
Does alcohol have a high or low potency?
Alcohol has a low potency.
How is alcohol eliminated from the body?
Alcohol is eliminated by zero-order kinetics.
Describe the characteristics of zero-order kinetics.
There is no fixed half-life.
The rate of elimination is independent of drug concentration.
The same amount of a drug is eliminated over a given period of time.
Zero-order kinetics are linear on a linear scale.
Zero-order kinetics result when elimination processes are saturated.
Zero-order applies to ~5% of drugs.
i.e., ASA, heparin, warfarin, theophylline
Describe the primary alcohol metabolism system.
The alcohol dehydrogenases (ADH) are the primary route of alcohol metabolism.
ADH uses NAD+ to convert ethanol to acetaldehyde (and NADH).
It is used by the liver, the gut, and the brain.
What byproduct is produced by alcohol dehydrogenase? What are the consequences of this byproduct?
Excess NADH byproduct contributes to lactic acidosis and hypoglycemia.
Which enzyme system is upregulated in chronic alcohol abusers?
The microsomal ethanol oxidizing system (MEOS) system is upregulated in chronic alcohol abusers.
Describe the microsomal ethanol oxidizing system (MEOS).
The MEOS system uses NADPH and O2 to convert ethanol to acetaldehyde (and NADP+ + H2O).
Which CYPs are used in the microsomal ethanol oxidizing system (MEOS)?
Describe the production of acetaldehyde and how it is converted to acetate.
Both ADH and MEOS systems produce acetaldehyde.
Acetaldehyde is converted to acetate by the aldehyde dehydrogenase (ALDH) enzyme.
Disulfiram inhibits aldehyde dehydrogenase (ALDH).
It is used as an aversive to discourage alcohol consumption.
Describe the signs and symptoms of acetaldehyde accumulation.
Describe the genetic basis of acetaldehyde accumulation.
It is caused by a genetic predisposition and some drugs.
East Asians are more likely to have deficient aldehyde dehydrogenase (ALDH2) or unusually rapid alcohol dehydrogenase.
These individuals are much less likely to abuse alcohol.
List the drugs that inhibit the ALDH enzyme.