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Binge drinking (male vs. female)
- Male: >4 drinks/day and/or >14 drinks/week
- Female: >3 drinks/day and/or >7 drinks/week
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% low or no drinking (not at risk or dependent)
66%
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In 12-17 year olds, males drink (more than/less than/the same as) females.
The same as
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In adults, males drink (more than/less than/the same as) females.
More than
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Alcohol dependence is (higher/lower) in college students than in older people. Binging is (higher/lower) in college students than in older people.
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Presence of food in stomach makes absorption of alcohol (faster/slower).
- Slower
- Milk particularly effective in delaying absorption
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Carbonated alcoholic beverages are absorbed (faster/slower) than non-carbonated.
Faster
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Alcohol use and traffic accidents
- Alcohol related accidents peak Friday night and Saturday night after midnight
- Relative risk increases with increased BAC
- Relative risk also age-dependent
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Wernicke-Korsakoff syndrome
- Wernicke's encephalopathy: confusion, eye abnormalities, ataxia (loss of muscle coordination)
- Korsakoff's psychosis: memory problems, confabulation
- Combination of the two caused by vitamin B (thiamine) deficiency due to alcohol abuse
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Acute effects of alcohol
- Hangover
- Tremor
- GI problems
- Alcohol hallucinosis
- Delirium tremens
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Alcohol hallucinosis
- Hallucinations
- Develops within 12-24 hours of drinking, goes away pretty quickly
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Delirium tremens
- Occurs 3-4 days after stopping or decreasing of heavy alcohol drinking in dependent individual (alcohol withdrawal)
- Confusion, disorientation, hallucinations, vital signs all over the place
- Can be fatal
- Treated with benzodiazepines
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Three-factor vulnerability model of alcohol abuse
Biological, psychological, and sociocultural factors contribute to development of alcohol abuse
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Most common cause of mental retardation in the US
Fetal alcohol exposure
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Symptoms of Fetal Alcohol Syndrome
- Mental retardation
- Low birthweight
- Neurological problems
- Distinctive facial malformations
- Other physical abnormalities
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Metabolism of alcohol
- Alcohol --(alcohol dehydrogenase)---> acetaldehyde --(acetaldehyde dehydrogenase)---> acetic acid --(oxidation)---> CO2 + H2O + energy
- Accumulation of acetaldehyde: leads to flushing, nausea, headache, increased heart rate
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Why some Asians can't drink that much
Low levels of acetaldehyde dehydrogenase (ALDH), so increased acetaldehyde, leading to side effects
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Aspirin effects on alcohol metabolism
- Particularly for females
- Aspirin inhibits gut alcohol dehydrogenase, so get drunk faster (increases BAC)
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Alcohol dehydrogenase levels are higher in (men/women).
Men
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P450 metabolism of alcohol; acute vs. chronic
- Acute: metabolized almost completely by alcohol dehydrogenase; acute levels of alcohol block this P450 system, leading to potentially dangerously high levels of other drugs
- Chronic: induces this P450 system; lowers levels of certain medications except during drinking periods; the 1st order kinetics as opposed to 0 order is one possible reason for tolerance
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Women get a (higher/lower) BAC than males of the same weight drinking the same amount of alcohol
Higher
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4 Neurotransmitter systems affected by alcohol: acute vs chronic effects
- Glutamate: Acute- receptor antagonism; chronic- up-regulation of receptors
- GABA: Acute- enhances GABA (more Cl influx to hyperpolarize); chronic- decrease in GABA function
- Dopamine: acute- increase; chronic- decrease
- Opioids: acute- increase; chronic- decrease
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Alcohol effects on GABA (acute vs. chronic)
- Acute alcohol increases GABA
- Chronic alcohol decreases GABA (and to get back to normal level, drink)
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First step in alcoholism treatment
Detoxification
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What can you give to an alcoholic trying to detox to help with withdrawal
Benzodiazepines
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Two drugs for alcoholism treatments
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Naltrexone
- Opiate receptor antagonist
- Decreases "high" of alcohol by blocking the effects of alcohol-induced endorphin release
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Acamprosate
- Partial antagonist of glutamate NMDA receptor
- Significantly blocks glutamate increase that occurs during alcohol withdrawal
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