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Psychopharmacology > Lecture 9: Alcohol and Inhalants > Flashcards

Lecture 9: Alcohol and Inhalants Flashcards

1
Q

what is 1 serving of alcohol? (4)

A

0.6oz, 14 grams of pure alcohol

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2
Q

1 serving of beer

A

12 fl oz, 5% alc

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3
Q

1 serving of malt liquor

A

8-9 fl oz, 7% alc

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4
Q

1 serving of table wine

A

5 fl oz, 12% alc

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5
Q

1 serving of shots

A

1.5 fl oz, 40% alc

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6
Q

approx how many americans are alcoholics?

A

18 million, 1 in 8

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7
Q

males are ___ as likely to suffer from alcoholism

A

2x

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8
Q

alcohol problems account for annual expense of

A

$185bn

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9
Q

in 2009, how many ER admissions were related to alc use?

A

600,000+

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10
Q

is alcohol water or fat soluble?

A

both

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11
Q

how much of alc is absorbed in stomach?

A

20%

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12
Q

3 variables that most affect alc absorption

A
  1. presence of food, slows
  2. volume and concentration of dose
  3. alcohol is irritant and increases flow of HCl and pepsin
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13
Q

how much of alc is absorbed through upper intestine?

A

80%

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14
Q

time from last drink to maximal absorp in blood is ___

A

15-60 min

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15
Q

95% of alcohol metab by ___

A

alcohol dehydrogenase

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16
Q

___ of alc is excreted through lungs

A

5%

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17
Q

___ of metab occurs in stomach by ____

A

10-15%; gastric alcohol dehydrogenase enzyme

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18
Q

___ in liver and involves ___ enzymes

A

80-85%, P450 enzymes

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19
Q

concentration of alc in exhaled air vs venous blood

A

1:2,300

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20
Q

women have ___ gastric metbolism, because they have less of ___

A

50%, gastric alcohol dehydrogenase enzyme

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21
Q

2 more reasons men have lower BAC

A
  1. greater muscle to fat ratio, so more places for alc to spread (fat has little blood supply)
  2. men weigh more
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22
Q

alcohol is converted to ___ via ___. coenzyme?

A

acetaldehyde via alcohol dehydrogenase

nicotinamide adenine dinucleotide (NAD)

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23
Q

rate limiting step of alcohol metab

A

availability of NAD

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24
Q

2nd step of alcohol metabolism

A

aldehyde dehydrogenase converts acetaldehyde to acetic acid

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25
Q

what does disulfram do?

A

irreversibly inhibits aldehyde dehydrogenase, leaving carcinogenic acetaldehyde behind

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26
Q

3rd step of alcohol metabolism

A

acetic acid broken down into CO2 and water

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27
Q

it takes ___ to metabolize the amt of alc contained in standard serving

A

1 hour

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28
Q

first threshold for alcohol impairment ; what is its effect?

A

0.04

impaired judgment and reaction time, decreased inhibition

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29
Q

risk of accident at 0.1-0.14? at 0.15+?

A

6-7x increased risk

25x increased risk

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30
Q

2 minor metabolites of alcohol that can be detected even at BAC 0

A

ethyl glucoronide and ethyl sulfate

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31
Q

unitary hypothesis of alc pharmacodynamics. what thing does it account for, and what does it not account for?

A

alc dissolves in nerve membranes thus distorting membrane like gen anesthetics

  1. generalized depressant behavior effect
  2. does not account for ability to disturb synaptic activity of glu and GABA and intracellular transduction
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32
Q

ethanol potently inhibits ___ receptors for ___

A

inhibits NMDA glu receptors, leading to decreased cog functioning

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33
Q

chronic alcohol use leads to persistent ___ suppression, which leads to

A

glutamate suppression, leading to compensatory up-reg of NMDA receptors

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34
Q

sudden cessation of alcohol leads to excess ___ excitation, which can cause ___

A

NMDAR

excitatory neuronal nerve damage and loss due to Ca2+ toxicity

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35
Q

alcohol enhances ___, and indirectly

A

GABA neurotransmission

augments dopaminergic projection from VTA to NA and frontal cortex

36
Q

4 behavioral effects from stim of GABA receptors

A
  1. sedation
  2. muscle relaxation
  3. inhibition of cog and motor skills
  4. reduced concern about action consequences
37
Q

opioid antagonist that leads to anticraving

A

naltrexone

38
Q

alc effect on 5HT receptors

A

augments serotonergic activity in NA (5HT2 and 5HT3)

39
Q

___ reduce drinking in alcoholics of lower severity

A

SSRIs

40
Q

chronic alc consumption stimulates synth of ___, the NT for ___

A

anandamide

cannabinoid receptors

41
Q

anandamide ___ cannabinoid receptors

A

activates and down regulates

42
Q

alcohol cessation leads to hyperactive ___

A

anandamide reaction

43
Q

alc fx on respiration

A

stimulated at low doses, then depresses

44
Q

benefits of low doses of alcohol (3)

A
  1. reduce risk of coronary and peripheral artery disease, because increase high-density lipoprotein and decrease low-density lipoprotein
  2. also decreases platelet aggression, protecting heart
  3. reduce incidence of ischemic strokes
45
Q

alcohol implicated in ____ of homicides and assaults

A

over 50%

46
Q

5 results of BAC 0.05-0.09

A
  1. increased sociability
  2. decreased inhibition
  3. less attn/judgment/ctrl
  4. slowed info processing
  5. loss of efficiency
47
Q

2 results of BAC 0.25-0.3

A
  1. ability to transcribe memory proteins from genetic material is impaired
  2. blackouts
48
Q

alcohol myopia

A

shortsightedness in which superficially understood, immediate aspects of experience have disprop influence on behavior and cognition

49
Q

in alc dependent adolescents, alc withdrawal leads to ___

A

persistent poor tretrieval of verbal and nonverbal info

50
Q

binge drinking def

A

drinking 5+ drinks in a short period for men or 4+ for women

51
Q

3 negative effects of binge drinking

A
  1. wreaks havoc on brain structures related to learning and memory
  2. causes impairments in cognitive tasks for days to weeks after binge
  3. can cause long term learning deficits mainly due to glutamate excitotoxicity
52
Q

5 brain structures damaged in binge drinking rats

A
  1. hippocampus
  2. perirhinal cortex
  3. entorhinal cortex
  4. piriform cortex/olfactory bulb
  5. insular cortex
53
Q

3 types of alc tolerance

A
  1. metabolic
  2. tissue/functional
  3. associative contingent/homeostatic tolerance
54
Q

what % of tolerance does metabolic tol account for?

A

25%

55
Q

kindling

A

repeated withdrawals lead to increase in severity and greater likelihood of seizures

56
Q

2 mechanisms underlying alc amnesia

A
  1. disruption of limbic areas to prevent consolidation of encoded stimuli into lasting memory traces
  2. alcohol blocks memory protein formation
57
Q

what is alcohol demtnai?

A

korsakoff’s syndrome; caused by severe deficiency of vitamin B1, leading to chronic memory disorder

58
Q

75% of alcoholism attrib deaths are due to ___

A

liver cirrhosis

59
Q

is alcohol a carcinogen?

A

no; it is a co-carcinogen because acetaldehyde promotes tumor growth

60
Q

fetal alcohol syndrome occurs in ___ born to alcoholic women

A

30-50%

61
Q

5 symptoms of FAS

A
  1. mental retardation/reduced brain size
  2. behavioral abnormalities (like ADHD)
  3. retarded body growth rate
  4. possible congenital heart defects
  5. facial abnormalities
62
Q

3 behavioral and cognitive effects of alc exposure (alcoholr elated neurodevelopmental disorder). why?

A
  1. cog dysfunction (impaired intelligence, etc)
  2. sensory dysfunction
  3. behavioral dysfunction
    alc competes with synthesis of retinoic acid, required for normal fetal brain dev
63
Q

___ of youth (14-18 yrs) with problematic drinking exhibit comorbidity for depression, PDs, substance abuse

A

80%

64
Q

5 treatment strats for alc use

A
  1. reverse acute pharmacological effects (but can’t b/c no unitary receptor)
  2. treat and prevent withdrawal
  3. maintain abstinence
  4. treat comorbid disorder
  5. limit neuronal damage by blocking w/d induced glutamatergic activation
65
Q

long-acting benzo used in alc w/d

A

librium, valium

66
Q

fast-acting benzo to prevent acute seizures

A

lorazepam

67
Q

GABA and NMDA receptor modulator

A

acamprosate

68
Q

4 pharmacotherapies in dev for alc

A
  1. cannabinoid receptor antag (rimonabat)
  2. partial nicotinic agonists (chantix)
  3. dopaminergic drugs (wellbutrin)
  4. serotonergic drugs (SSRIs)
69
Q

effect of cannabinoid receptor antag; limitations

A

reduce drinking by inhibiting mesolimbic DA pathway

low efficacy and side fx like depression and anxiety

70
Q

effect of nicotinic agonists

A

reduce alc consumption and rate of relapse

71
Q

effect of dopaminergic drugs

A

alcohol w/d causes hypofunction of mesolimbic DA system, may treat depression

72
Q

7 interacting NT sys in alcoholism

A
  1. opioid
  2. dopaminergic
  3. serotonergic
  4. endocannabinoid
  5. nicotinic
  6. GABA
  7. glu
73
Q

primary fx of sys on alcoholism: opioid

A

reinforcing and craving

74
Q

primary fx of sys on alcoholism: dopaminergic

A

reinforcing, craving

75
Q

primary fx of sys on alcoholism: serotonergic

A

affective dysreg

76
Q

primary fx of sys on alcoholism: endocannabinoid

A

craving, relapse

77
Q

primary fx of sys on alcoholism: nicotinic

A

reinforcing

78
Q

primary fx of sys on alcoholism: GABA

A

reinforcing

79
Q

primary fx of sys on alcoholism: glu

A

cognitive functioning

80
Q

who is most likely to abuse inhalants?

A

12-17 years; more 12 year olds used inhalants than other drugs

81
Q

3 reasons inhalants are popular

A
  1. low cost
  2. available
  3. rapid onset
82
Q

7 acute effects of inhalants

A
  1. intoxification
  2. disorientation
  3. slurred speech
  4. impaired judgment
  5. euphoria
  6. dizziness
  7. delirium
83
Q

sudden sniffing death syndrome

A

lack of oxygen to brain, cardiac arrhythmias, aspiration of vomit, trauma, frozen lungs; contain volatile hydrocarbons, which sensitive heart to serious arryhtmias. if startled while intoxicated, sudden adrenaline surge acts on heart to set off life-threatening arrhythmias

84
Q

8 effects of long term inhalant use

A
  1. liver and kidney failure
  2. dementia
  3. cog dysfunction
  4. loss of coord
  5. weight loss
  6. muscle weakness
  7. irritability
  8. depression
85
Q

primary acute treatment for inhalants

A

supplemental oxygen

86
Q

5 treatment approaches for inhalants

A
  1. detox
  2. medical/neurological eval
  3. neurocog assessment and rehab
  4. occupational/physical therapy
  5. afterschool care

Psychopharmacology (22 decks)

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