Drinking and Hangovers

8/7/2019 Drinking and Hangovers

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Drinking and Hangovers

Albert Francis E. Domingo, MD

http://AlbertDomingo.com


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Ethanol disturbs the fine balancethat exists between excitatory and

inhibitory influences in the brain,producing the disinhibition, ataxia,

and sedation that follow itsconsumption.


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(% v/v)

Beer 4-6Wine 10-15

Distilled Spirits

(Hard)

>= 40

Proof = two times the percentage alcohol (v/v)


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A typical serving size of alcoholic beverage (1

beer bottle, 1 glass wine, 1 shot tequila, etc) is

adjusted to yield 14 grams of ethanol.

One serving of alcoholic beverage when

consumed results in 30 mg/dL Blood Alcohol

Level (BAL) in a typical 70 kg person.

The legal limit is usually 80-100 mg/dL BAL


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Alcohol and its Effects

Depressant, notstimulant

Behavioral disinhibitor

Beer Goggles

Individual signs of intox

vary from expansive

and vivacious affect, to

uncontrolled moodswings and emotional

outbursts with violent

components


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Acute Alcohol Intoxication

Blood Alcohol Level (mg/dL) Effects

20-30

(1 serving)

Increased reaction time

Diminished fine motor

control

Impulsivity and impairedjudgment (beer goggles)

80-100 mg/dL LEGAL LIMIT

150 mg/dL

(5 servings)

Gross intoxication

400 mg/dL

(13-14 servings) DEATH


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More severe intoxication presents similarly to General

Anesthesia, with little margin between anesthetic and lethal

effects.

Ethanol itself is neurotoxic; neurons (approx. 1M) are lost

when intoxicated.


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Alcohol and the Human Body

1. Rate of drinking

2. Gender

3. Body weight and water percentage

4. Rates of metabolism and stomach

emptying


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Absorption


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Absorption

More rapid in the small intestine than in the

stomach

Pulutan or food delays stomach emptying,

leading to slowerethanol absorption

Alcohol Dehydrogenase (ADH)

Gastric ADH: less in women, more in men

Hepatic ADH


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Metabolism, Excretion

Absorption(Stomach,Small Intestine)

Metabolism(ADH)

Excretion(Urine)

EthanolAcetaldehyde Acetate


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Rule of Thumb

For individuals with normal hepatic

function, ethanol is metabolized at a rate

of

1 standard drink every 60-90 minutes

(BAL is reduced by 15 mg/dL per hour)


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The Hangover

EthanolAcetaldehyde Acetate

When acetaldehyde accumulates in the blood,flushing, tachycardia, hyperventilation, and

nausea occur.

The best hangover remedy is based on the

principles of ethanol excretion: WATER


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END


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References

Goodman & Gilmans The Pharmacological Basis ofTherapeutics. 10th ed. (2001). New York: McGraw-Hill.

Mycek, MJ et al. (2000). Lippincotts IllustratedReviews: Pharmacology. Philadelphia: Lippincott-Raven.

*Photographs are properties of their respectivecopyright owners.

Drinking and Hangovers

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