Alcohol (ethanol): Pharmacological effects Chih-Chia Lai Department of Pharmacology Tzu Chi University 2009-10-30 Drugs of Abuse(濫用藥物) – 類鴉片藥物: • Heroine, Morphine – 中樞神經興奮劑: • Amphetamine, Methamphetamine, MDMA, Cocaine – 中樞神經抑制劑: • FM2 – 中樞神經幻覺劑: • Ketamine, LSD, Marijuana, Phencyclidine (angel dust) – 酒精(alcohol)和尼古丁(nicotine) 1
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Alcohol (ethanol): Pharmacological effectsls.tcu.edu.tw/cclai/Userdata/File/Alcohol.pdf · Excessive alcohol (alcohol abuse) use can result in serious physical and mental problems.
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a substance, other than food, used in the prevention, diagnosis,alleviation, treatment, or cure of disease
A substance other than food intended to affect the structure or function of the body
Alcohol is a psychoactive drug that is a CNS (central nervous system) depressant
Alcohol is the second most widely used and abused of all psychoactive drugs
Alcohol is an addictive drug Alcohol is considered as a social lubricant
Why people view alcohol as a non-drug
Alcohol is legalAdvertising and media promote drinking as
normalLarge distribution and sales of alcoholLong history of alcohol use
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Excessive alcohol (alcohol abuse) use can result in serious physical and mental problems.
Chronic excessive use that involves a compulsion to drink, increased tolerance, and withdrawal symptoms is called alcohol dependence or, alternatively, alcoholism. Tolerance: the capacity of the body to endure or become less
responsive to a substance (as a drug) or a physiological insult with repeated use or exposure
Withdrawal syndrome: the development of a substance-specific syndrome that follows the cessation of, or reduction in, intake of a psychoactive substance that the person previously used regularly
Negative Impact of Alcohol
Chronic tolerance: produced by repeated administration of ethanol over a period of days or weeks.
Acute tolerance (tachyphylaxis): that appears within minutes after a single dose.
Cross-tolerance: the resistance to one or several effects of a compound as a result of tolerance developed to a pharmacologically similar compound. It is common practice to take alcohol concurrently with other drugs
Ethanol Tolerance
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Physical dependence manifested by withdrawal reactions: hyperexcitability in mild cases, convulsion, toxic psychosis, and delirium tremens (酒狂) in severe ones. The severity of withdrawal reactions depends on dose and frequency of use, and may be life threatening.
Psychological dependence is characterized by a compulsive desire (or craving) to experience the rewarding effects of alcohol or to avoid the negative consequences of withdrawal.
Ethanol dependence
• In recent years dozens of cohort studies from all over the world have associated moderate alcohol consumption with reduced risk for cardiovascular disease, decreased overall mortality rates and other potentially improved health conditions.
Positive Impact of AlcoholModerate consumption of alcohol may prolong life span
Alcohol & CaloriesAlcoholic beverages have no vitamins,
minerals, protein, or fat – just a large amount of carbohydrates and usually caloriesAlcohol provides more calories per gram
than does carbohydrate or protein and only slightly less than does pure fat. Because it can provide many calories, the drinker’s appetite may be satisfied; as a result, he or she may not eat properly, casuing alnutrition.
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The Hangover
The symptoms: fatigue combined with nausea, upset stomach, headache, sensitivity to sound, and ill temperThese symptoms are usually most severe
many hours after drinking, when little or no alcohol remains in the body.No simple explanation exists for what
causes the hangover.
Effects of Alcohol on Organ Systems and Bodily Functions
• Brain and nervous system• Liver• Digestive system• Blood• Cardiovascular system• Sexual organs• Endocrine system• Kidneys
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• Alcohol causes a spectrum of liver injury that can progress from fatty liver to alcoholic hepatitis(often considered an intermediate stage) to cirrhosis.
• As little as 20 g of alcohol in women or 60 g in men can cause serious liver damage when consumed daily for several years. Consuming more than 60 g/day for 2 to 4 wk produces fatty liver even in otherwise healthy men; 80 g/day may lead to alcoholic hepatitis; and 160 g/day over a decade can lead to cirrhosis.
The effects of Alcohol on Liver
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The National Institute on Alcohol Abuse and Alcoholism defines moderate alcohol consumption as “no more than two standard drinks per day for most men and no more than one standard drink per day for most women.” A standard drink contains 12 g of alcohol.
It have suggested that one to two standard drinks per day is associated with reduced risk of coronary artery disease.
24 g alcohol per day (two drinks) reduced the risk of ischemic stroke and total stroke.
American Heart Association/American College of Cardiology science advisories conclude that in the absence of proof of causality, the use of alcohol as a cardioprotective strategy is not recommended.
The cardiovascular effects of Alcohol: the Good
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The adverse effects of immoderate alcohol consumption on the cardiovascular system include cardiomyopathy, hypertension, cardiac arrhythmias, and stroke.
Alcoholic cardiomyopathy generally occurs after long-term, heavy drinking (more than six standard drinks per day for longer than five years).
Studies show an association between long-term alcohol consumption of 30 to 60 g (three to five drinks) or more per day and higher systolic and diastolic blood pressures
60 g or more alcohol per day per day increased the risk of ischemic stroke and total stroke.
Heavy, long-term drinking and binge drinking also are associated with atrial and ventricular arrhythmias, some nonspecific electrocardiographic changes, and sudden cardiac death
The cardiovascular effects of Alcohol: the Bad
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The following dialogues from Shakespeare describe some of the effects of alcohol.Macbeth (Act 2, scene 3):
Macduff: What three things does drink provoke?Porter: Marry, sir, nose-painting, sleep, and urine.
Leachery, sir, it provokes, and unprovokes;It provokes the desire, but it takes away theperformance.
Effects of Alcohol on Sexual Organs
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Alcohol and Pregnancy
Moderate to excessive drinking during pregnancy can result in – Spontaneous abortion– Damage to fetus (fetal alcohol syndrome, FAS)
• Damage dose-related• A safe lower level of alcohol consumption has
not been established for pregnant women
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Fetal alcohol syndrome (FAS)
Facial abnormalities, where there is an increased distance between the inner corners of the eyes, and a thin upper lip.
Mild to severe mental retardation resulting in learning difficulties.
Low birth weight and height that persists through early childhood.