Alcohol Chapter for Exam 3

-fermented beverages do not have an alcohol content higher than___% -depends on what type of ___-containing substance is used -____was invented to increase the alcohol content -because alcohol has a lower ___ ____ than water the steam emitted thru boiling has greater alcohol content than does the original fermented mixture -the vapor is then condensed thru cooling and resulting liquid has a ____ _____ ____ than the original fermented mixture -______ this cycle raises the alcohol content of a beverage to progressively higher levels

15% sugar distillation boiling point greater alcohol content repeating

Consumption changes -The average American drinkers: ___-___ standard drinks per day -Currently: ___-___ standard drinks per week

4-5 3-4

SITES OF ACTION page 211 -depresses the ____ -may dissolve in ___ membranes that disturbs normal chemical reactions -alters cell ____ _____ by entering their internal structure -results in a reduces efficiency of conduction of _____ ______ along axons which reduces the action potential amplitude that that reaches the _____ -nt release and transmission are _____ across the synapse -acts on GABA-_____ receptors as well as enhancing _____ and ____ activity -effects all neurochemical systems and _____ systems

CNS lipid membranes anatomy neural impulses synapse inhibited benzodiazepine dopaminergic and serotoninergic endocrine

Behavioral Effects -.15-.16% _______ functions seriously impaired (staggering, blurred vision, slurred speech) ______ functions impaired: serious loss of judgement and emotional control 0.20% ______ functioning affected: needs to lie down, may sleep or pass out may vomit (protective response; also take precautions) -.30% Likely to pass out and can't be awakened from sleep ->.35-40% Coma likely; may reach lethal dose -.45-50% ____ __ in humans Behavioral Effects (cont'd) -often viewed as stimulated by public (NO) CNS _____- similar to BZs -wide variety of effects _____ and disinhibition -General impairment of CNS at higher doses Eventual general anesthesia Little margin b/w LD 50 and anesthesia

Cerebellum Cortical Midbrain LD 50 depressant Antianxiety

Alcohol- Types ____(grain alcohol) -produced by fermentation ____ (wood alcohol) -produces synthetically -antifreeze, fuel _____ (rubbing alcohol)

Ethyl Methyl Isopropyl

The ____ _____ page 236 -the co-occurrence of a diet high in saturated fats and a low incidence of coronary heart disease -red wine associated - resveratrol a non-alcoholic component of red wine

French paradox

Metabolism (cont'd) -_____ action Interferes with other metabolism -____ _____ build up in liver Leads to cell death ______ of liver

Liver Fatty acids Cirrhosis

Broad Scope -alcohol ____ and ____ are major health problems in US and many other countries -economic burden ~250B a year -medical and social impacts -100,000 deaths/year -14 million (1:20) meet criteria for alcohol abuse or alcoholism -Diagnosis and treatment often ____ until disease is advanced -complicated by social and health issues difficulty Tx

abuse alcoholism delayed

Metabolism -_____ ______: mutations of enzymes im south western NA decent make it quicker to metabolize alcohol so it takes more to achieve desire effects -______ _______: mutation in Asian decent that have a harder time breaking down alcohol so it builds up causes red cheeks and makes them feel sicker when they drink Alcohol Acetaldehyde Acetate Carbon dioxide water energy alcohol dehydrogenase aldehyde dehydrogenase

alcohol dehydrogenase aldehyde dehydrogenase

Fetal alcohol syndrome page 233 -a characteristic set of symptoms that appear in some newborns of mothers who drink during pregnancy -falls into the class of ____ ____: the study of monsters or deformities -small eyes and small eye openings drooping eyelids underdeveloped mid face skin folds across the inner corners of the eyes, _____ of the depression above the upper lip and a small head circumference. Reported abnormal creases in the palms and abnormalities in the joints -some cardiac defects, benign tumors consisting of dilated blood vessels and minor ear abnormalities -10 yr follow up showed low-normal to severely retarded intellectual functioning, physical deformities similar to those previously reported and the development of additional physical problems -other factors: _____ __ ____ at delivery, mothers' pattern of alcohol consumption during pregnancy gravidity, and parity -if other ____ are taken by the mother during pregnancy then they may have similar effects to alcohol -if you are pregnant do not drink overall

alcohol teratology underdevelopment age of mother drugs

Physiological effects page 219 -inhibits the secretion of the ____ hormone which causes urination -happens when bac is ____ and not ____ -reduces the amount of body fat that is oxidized leading to increase in fat -peripheral ____ and causes the skin to feel warm and turn red -increases gastric secretions and stimulates ____ -alcohol at high amounts harms the _____ _____ and causes gastric diseases -nausea and vomiting may occur at bacs higher than ____% -rapid release of _____ as part of the body's general reaction to stress -disruption of ___ sleep is suppressed throughout the night -impairs memory acute effects are short term memory loss when high bacs are reached rapidly causing ____

antidiuretic rising falling dilator appetites stomachs mucosa 0.15% corticosteroids REM blackouts

Fermentation and distillation -three classes: ____ _____ and ____ -depends on fermentation and distillation process

beer wine liquor

-____ ______: consuming at least 5 for men or 4 for women drinks on at least one occasion -accidental death injury assault unwanted and unprotected sex drunk driving vandalism suicide and academic problems -first year students white's members of frats and sororities and athletes drink the most

binge drinking

Distribution page 212 -distributes to all ____ ____ -easily dissolved in water and the proportion of water in a tissue determines the _____ of alcohol in it -____ is about 70% water therefore it gets a high content of alcohol -muscle and bones have smaller -effects primarily the ___ and the ____ -freely passes thru the ____ ____ ____ -average adult reaches ___ __ after 25 drinks in an hour or so -standard drink: 0.6 ounces of alcohol or 1.5 ounces of distilled spirits, 12 ounces of 5% beer or 5 ounces of table wine (12% alcohol) -___ the amount of alcohol in the bloodstream expressed as a percentage of of weight of alcohol per 100 units of blood volume -heavier people have a ____ bac -alcohol is soluble in fat but more soluble in ____ -formula for bac -measured by ____ analysis

body tissues concentration blood CNS brain blood brain barrier LD 50 BAC lower water breath

Alcohol and reproductive functioning page 233 -both men and women suffer impaired reproductive functioning as a result of ____ _____ ____ -in men: male sex hormones, reflexive responses of the nervous system relating to sexual performance and sperm production -leads to loss of sex drive and altering of hormones -in women: dysfunction of the ovaries and luteal phase of fertilization and amenorrhea

chronic heavy drinking

Therapeutic uses page 218 -thought to be a remedy for ____ false -due to the fact that it is an excellent solvent small amounts are combined with ____ _____ and other products taken orally -mouthwashes shaving lotions -recommended to elderly to stimulate ____ and digestion -treat skin problems -ethanol cool sponges uses to treat fever -dehydrated alcohol may be injected close to the nerves or sympathetic ganglia to relive ____ _____ that may occur such as patients with inoperable cancer

colds cough syrups appetite chronic pain

Additionally... Cardiovascular System -Cardioprotective Effects? Very Low Amounts 10-40% reduced risk of _____ _____ _____ ____-shaped dose mortality curve: low dose range you can see the slight cardioprotective effects

coronary heart disease J

Alcohol and Pregnancy (Fetal Alcohol Spectral Disorders) -Not rigorously noted till later in 20th century -FAS Typical diagnosis: Cluster of ____ abnormalities ___dysfunction Pre and or postnatal stunting of growth Hearing language and speech disorders -FAE is partial phenotype Metal deficits Attentional deficits and hyperactivity

craniofacial CNS

Also -_____ blood vessels -_____ body temperature -_____ internal stress response -_____ effect of other depressant drugs

dilates decreases activates increases

Tolerance page 216 -regular use results in some ____ tolerance- must consume greater amounts of alcohol to achieve higher bac. Can be reversed within a period of ___ from alcohol -acute and protracted -____ _____ with drugs that are cns depressants -______ such as valium and lirbrium show cross dependence with alcohol -used in place for _____ symptoms from alcohol to help ease them

dispositional abstinence cross dependence benzodiazepines withdrawal

Effects of chronic heavy drinking page 228 -increased _____ that may be fatal -some effects caused by alcohols toxicity to the body as such damage to the _____ -___ _____ related to long term heavy drinking and involves impaired cognitive functioning is caused by nutritional deficiencies that occur in people who are dependent on alcohol -no more than ____ drinks in one day and no more than 14 in a week for men and for women no more than ___ drinks and seven drinks -in 2012 consumption of alcohol caused a total of 5.9% of global deaths Europe then American at highest -typical acute effects of alcohol with ascending and descending bacs char page 229 -possibly beneficial health effects with ____ use of alcohol -page 230 chart on effects of chronic heavy drinking on body systems -effects two prominent systems ____ and the ____ -also extend to _____ functioning bc of altering effects on the hypothalamic pituitary gonadal endocrine axis and with fetal alcohol syndrome

dysfunction liver Wernicke's disease 4 3 moderate brain and liver reproductive

Psychological effects page 224 -change _____ and _____ -mood state ____ drinking is an important factor -lower bacs elevated and friendly mood as it rises when it falls includes anger and fatigue -rising also includes expansiveness joviality relaxation self-confidence also hostile depresses and withdrawn -when bacs go over 0.10% become labile and change from friendly to hostile -significantly impairs ____ _____ ____ ____ at bacs higher than 0.05% as well as ability to estimate time and distance

emotion and mood before short term memory loss

GI System -____ (reflux, cancer) -stomach (gastritis) -intensive (chronic diarrhea, malabsorption) -_____ (inflammation, pain)

esophagus pancreas

Alcohol -refers to many substances: isopropyl alcohol methyl alcohol and ethanol -____is the alcohol we drink

ethanol

Mechanism of Action -disturbs done balance between ____ and ____ neurotransmission Mainly ____ and ____ receptors -Number of putative sites of action have been identified Overall effect is the sum of effects at numerous proteins that effect neuronal excitability *Net effect of alcohol at all these different sites

excitatory inhibitory GABA glutamate

Brain maturation -_____: occurs 24-25 -____: early 30s -last to develop are ____ ____ structures -regions important for executive control -legal drinking age is protective should actually be _____

females males frontal cortex later

sugar is dissolved in water and expose to air which creates the perfect environment for microorganisms called yeasts

fermentation

Absorption page 211 -formally classified as ___ because it provides calories -passes from ____ to _____ for rapid absorption -can be vaporized from ____ and subcutaneous sites -factors that influence: eating, milk consumption, rate at which it Is consumed, carbonation more quickly -the time between ______drinking and peak alcohol levels is 30 to 90 minutes -______ prevents what is ever in the stomach from passing into the intestines. 10-20% of alcohol is absorbed -other alcohol remains in stomach and is a natural _____ to prevent heavy drinking tendencies

food stomach to intestine lungs stopping pylorospasm defense

Per capita consumption in the united states page 206 -showed an increase in rates from 1935 into the 1940s -increase In the 60s and 70s -1980 marked a decline then reversed in 1990 -decline again from 1995-2012 -the reduction in 1980-mid 1990s was due to the decline in the use of ____ ____ -the data on per capita alcohol consumption tell us how much average drinkers in the us consume although there are various factors that effect this; age gender ethnic/racial background -heavy drinking associated with ____ consequences; health problems accidents job and family problems and symptoms of dependence -heavy drinking was defined as ____/___drinks on an occasion at least 5 days in the past 30 days -6.5% of the population reported heavy drinking in the last month in 2015 -men reported a rate ___x women -10.9 of 18-25-year old reported heavy drinking -rate for men in this group: 13.6% for men 8.2% for women -_____ have higher rages 14.2% than blacks 5.7% and Hispanics 8.0%

hard liquor negative 5/4 2x whites

Behavioral Effects (Table 9.5 in the text) -0.4% lowered cortical efficiency some impairment of _____ some release of inhibitions -0.5-0.6% effects more noticeable (emotions, judgement and inhibitions) -0.08-0.10% Noticeable effects on ____ functioning 1. decreased fine motor skills 2. delayed reaction time 3. increased clumsiness 4. decreased peripheral vision 5.decreased balance and coordination

judgement cerebellum

ADMET (T) -_____ volume required for physiological effects -consumed more like a food than a drug -consumed/dosage in ____ quantities (14 g per drink) -BALs (____ ____ ______) readily estimated expired air (high partition coefficient)

large gram Blood Alcohol Levels

Metabolism and excretion page 215 -90% of alcohol absorbed and metabolized by the body is mainly by the ____ -small perecntagae is relased from the ____ and the ____ -in the liver it is broken down into _____ by the enzyme alcohol _____ -drug that makes them feel sick after ingesting alcohol: ____ -acetaldehyde is eventually broken down into ___ and h2o -co2 relased in air h20 in urine -rate of alcohol oxidation is 0.35 ounces per hour -_____: released in forms of heat and work

liver kidneys lungs acetaldehyde dehydrogenase disulfiram co2 oxidation

Alcohol and brain functioning page 231 -if drunk long and heavy enough effects of short-term memory and other cognitive functions could be experienced ___ ____ -varies in severity evidence from neuropsychological tests -when without alcohol subjects preform ____ than nonalcohol users -impairments associated with ____ of alcohol -drinking history may also impact -long term ____ reverses these effects to mild due to possible increased cerebral flow better nutrition reorganization of brain cell networks and some memory of brain atrophy

long term worse dependence abstinence

Excretion -~2-8% unchanged through the ____ -90-95% oxidized slowly..._____ -Alcohol increases urination Ingestion of liquid ______ of anti-diuretic hormones (ADH)

lungs kidney Suppression

Alcohol and the liver page 232 -major _____ ____ of alcohol is liver which is highly vulnerable to alcohols effects -damage occurs in three ways: ____ ____, _____ and _____ -___ ____ characterized by fat accumulating in the liver and is the earliest most benign effect of alcohol on the liver. Reversible with abstinence from alcohol and no evidence of precursor of cirrhosis -_____ ____ is more severe and involves the inflammation and death of liver cells. ______ often occurs. Reversible with abstinence of alcohol but can cause death if severe and not treated -_____ is the most dangerous and life threatening. Alcohol dependence leading cause of cirrhosis

metabolic site fatty liver, alcohol hepatitis, and cirrhosis fatty liver alcohol hepatitis Jaundice cirrhosis

Moderate drinking and health page 235 -____ drinkers turn out to be the healthiest followed by the ____ then the ____ drinkers -risk of ____ disease and mortality is defined as health -____ to ____ drinks a day smaller amounts in women than in men -moderate alcohol consumption protects against heart disease because it increases the production of high-density lipoproteins which take damaging cholesterol away from the artery walls -associated with lower risk for ____ disease -income effects show that lower income is more likely to be abstainers and have a greater vulnerability to cardiovascular disease than moderate drinkers

moderate abstainers heavy cardiovascular one to three coronary

Alcohol and driving ability page 221 -sensorimotor skills and driving ability risk -public awareness increased in the 80s: ____ _____ ____ ____ madd and students against drunk driving sadd -increased enforcement of stricter legal ______ from Dui's and revocation for anyone who fails or ____ to take a bac test -_____ _____ are the most common cause that Is nonnatural cause of death in the united states -leading death overall of people aged 15-24 years -____ people more at risk especially ____

mothers against drunk driving penalties refuses motor vehicles young men

History of alcohol use page 204 -first alcohol was made by the process of _____ ______ -thousands of years ago probably by using ____ ____ -first beer produced 6000 and 5000 b.c or as early as 10,000 years ago -first beer production was similar to the production of ____ -colonial America adopted alcoholic beverages from _____ -saloons created -behavior associated with the saloon led to the rebirth of the _____ movement -led to _____ and the Volstead act -prohibition _____ in nationally in 1933

natural fermentation fruit juices bread England temperance prohibition repealed

Absorption -___ route of administration Most common method -____ AWOL (alcohol without liquid) Higher blood alcohol levels (BALs) Banned in most states

oral Inhalation

Traditional approaches to etiology page 237 -US sees it as a ____ disease -sons and daughters of parents with more severe alcohol use disorder are ___x more likely to develop the disorder themselves -identical twins more likely than fraternal twins -specific ____ make them more at risk

physical 4x genes

Acute effects of alcohol page 218 -______, _____ _____ and psychological -acts on the body as a _____ -acute effects are proportional to the magnitude of _____ -aggression sexual behavior and driving are social concerns

physiological sensory motor depressant BAC

Alcohol as a reinforcer -_____ reinforcing effects: Gain pleasure Altered consciousness Conform to behavioral of peers -_____ reinforcing effects Relief of stress and negative emotions Relief of withdrawal symptoms

positive negative

Alcohol as a Progressive Illness -Alcohol seeking and craving Switch from controlled use to compulsivity ____ _____ is damaged: compromised executive function -Brian damage (Korsakoff Syndrome) Cognitive functioning and judgement Leading cause of _____ Loss of _____ and _____ matter -> shrinkages _____ ______ are particularly sensitive: greater detectability with increasing age

prefrontal cortex dementia white and gray Frontal lobes

Expressing alcohol content of a beverage page 202 -in the US alcohol is denoted by volume -16 oz of a beverage that is 50% ethanol contains 8 oz of alcohol -____is used primarily for distilled spirits and is equal to twice the percentage of alcohol by volume -a beverage that is 43% alcohol is ___ proof

proof 86

Physiological effects -failure of transition from ___ term memory to ____ term memory -____ appear 4-12 hours after reaching peak bac -headache dizziness nausea vomiting increased heart rate fatigue and thirst -reduced ability to perform complex skills even when bac is zero -cost us economy $90 billion in lost worker productivity -interact severely with _____ semi with benzo -histamines -decreases effects of certain ____meds: antibiotics anticonvulsants anticoagulants and monoamine oxidase inhibitors MAOs -causes slight ___ _____ at lower doses

short long hangovers barbiturates prescribed respiratory depression

-yeast multiplies rapidly eating the ___ that is then converted into ethanol and ___ ____ by the yeasts metabolic processes -the ___ _____ to the top of the mixture leaving ethanol

sugar carbon dioxide co2 bubbles

Sensorimotor effect page 221 -at moderate to higher bacs (0.05%) alcohol has several acute effects on the senses -_____ decreases in acuity and taste and smell are not so sensitive -_____ sensitivity decreases when bac is in the 0.8-0.10% -simple reaction time begins to ____ significantly at bac of 10% -complex reaction time may be impaired in both speed and accuracy at bacs of 0.05% or even lower -strongly effects body ____ -at bac 0.06% body sway is impaired about 40% -walk in a straight-line test -due to effects on ____ controls in the inner ear -impairs psychomotor skills deterioration at bacs about 0.03% and higher -impairs the brain centers responsible for motor activity and balance to such a degree that neural messages are not being sent to the ____

vision pain slow sway balance muscles

Wernicke-Korsakoff syndrome page 231 -cns disorder that results from the combo of extreme nutritional deficiency specifically ____ _ or ____ and chronic drinking -syndrome comprises ____ diseases -in the absence of permanent brain damage, it is reversible by giving the patient ____ ___ -_____ syndrome may have nutritional component but is primarily due to alcohol -most associated with ____ ____ to brain structure that most affects ____ -impairments of short-term memory and learning are serious -often considerable confusion and confabulation

vitamin b thiamine two vitamin b Korsakoff brain damage memory

Absorption -simple small molecule Soluble in ___ and ____ -Neutral particle...diffuses easily through membranes -Rapidly absorbed into blood stream _____ (slower) and ______ _______(faster) Distributed into total _____ _____ -What about food in the stomach Type/Amount _____ of alcohol Other drugs present ***alcohol is _____ ______ kinetics

water and lipids Stomach small intestine body water Concentration zero order

Distribution -____ of the individual -sex: due to different ____ to ___ ratios-greater concentrations in in women -cross metabolism effect changes with age -____% of blood brain barrier will cross thru and access brain

weight muscle to fat 90%