PSYCH 265 1st EditionExam #3 Study Guide Lectures: 15-25EXAM 3 STUDY GUIDECHAPTER 13 (pp. 333-345) 1. Describe the benzodiazepine-GABA chloride channel receptor complex and explain how it works. - Ionotropic receptor that is widely distributed in brain- Comprised of 5 proteins - Separate binding sites for GABA, barbiturates & benzodiazepines o Alcohol binds to GABA binding site2. Identify the therapeutic applications of different classes of barbiturate drugs. - Ultra-short acting-intravenous anesthetics (thiopental)- Short to intermediate acting-sedative hypnotic (secobarbital & pentobarbital)- Long acting-anticonvulsant (phenobarbital)3. Describe the consequences of chronic treatment with barbiturates. - Increasing the dosageo Sedation o To hypnosis (sleep)o To anesthesia o To coma o To death4. Compare and contrast the properties of barbiturates and benzodiazepines.CHAPTER 9 1. Describe how the various alcoholic beverages are made, and what their alcohol contents are, typically. What is "proof"? - Properties o Ethanol, U.S.P.= 95% EtOHo Anhydrous (absolute) EtOH= 100% EtOH- Proofo 2 x %EtOH content - Typical alcohol contents o 12 oz beer (3-6% ethanol by volume)o 5 oz wine (10-12%)o 1.5 oz distilled spirits (40-75%)2. Discuss the pharmacokinetics (absorption, distribution and excretion) of alcohol. - Absorption o 75-80% oral EtOH absorbed from small intestines; the rest absorbed from stomacho Presence of food slows rate of absorptiono Fasting state: >50% alcohol absorbed in 15 min Max blood level reached in 20 min 80-90% complete absorption within 30-60 min- Distribution o High affinity for water & totally distributed in total body watero After absorption is complete, equilibrium occurs and all blood in body contains same concentration of alcohol o Crosses placenta & can affect fetus o Total body water decreases w/ age so older person will be more affected by same amount of alcohol Age 18-40 M-61%, F-52% Age over 60 M-51%, F-46%- Excretiono Removed from bloodstream by combo of metabolism, excretion, and evaporation 90-95% metabolized ADH Cytochrome P450 (CYP) family Catalase 1-3% excreted in urine 1-5% evaporates through breath <.5% excreted in sweat, tears, feces, milk, ect3. Explain how alcohol is metabolized, plus individual differences in responses to alcohol due to pharmacogenetic differences. - Metabolism o ADH converts to alcol to acetaldehyde o Acetaldehyde is toxic by product of alcohol o ALDH converts acetaldehyde to acetic acid o Acetic acid is broken down to carbon dioxide and water Regardless of how much someone consumes, body can only metabolize certain amount every hour (zero-order kinetics)- Pharmacogeneticso ADH consists of 5 related enzymes o Several ADH enzymes (1, 2) show genetic polymorphism ADH2*2-faster than usual ADH2*3-faster than usual ADH3*1-faster than usual o People w/ ADH2*2 enzyme rapidly converts to acetaldehyde o Accumulation of acetaldehyde can produces vasodilation, sensation of warmth, headache & trembling o 2nd step is mediated by ALDH which converts acetaldehyde to acetate 4. Explain the mechanism of action and purpose of disulfiram (Antabuse®). - Completely blocks ALDHo Results in upward jolt of acetaldehyde concentration w/ serious hangover symptoms, plagues drug addicts in withdrawal state who are undergoing treatment, after any indulgence in alcohol5. Describe the dose-related effects of alcohol. - Increased dose of alcohol results in o No effecto Giddyo Sleep o Deep sleepo Unconscious o Labored breathing o Death 7. Describe the effects of alcohol on the liver, endocrine system, digestive tract and immune system. - Endocrine o Release of antidiuretic hormoneexcessive production of urine o Increase in blood sugaroverproduction of insulin o Interferes with how body absorbs Capredispose heavy drinkers in osteoporosis o Heavy male drinkers-loss of testosteroneerectile dysfunction & emotional changeso Heavy drinkingeasy bruising & acne- Digestive tracto Moderate consumption stimulates digestive juices & acid secretion o Low doseaccelerates gastric emptying o High dosedelays gastric emptying & slows bowel motilityo Excessive amounts damage lining of stomachinflammation or gastritis o Facilitates dev. Oraopharyngeal, esophageal, gastric, colon cancer- Liver o Cirrhosis medical complication of chronic alcoholism o Grave/irreversible condition characterized by progressive replacement of healthy liver tissue w/ scarsliver failure and death- Immune system o Excess consumption suppress immune systemsusceptibility to certain disease Pneumonia Tuberculosis Hep B & C Septicemia 8. Describe the different types of tolerance that can develop after alcohol consumption. - Behavioral o Behavioral compensation for effects of ethanol- Pharmacokinetic o Induction of cytochrome P450 enzymes that break down ethanol- Pharmacodynamico Adaptive changes in drug targets that make them less responsive to drug9. Describe the alcohol withdrawal syndrome. What makes alcohol withdrawal potentially lethal? - Minor o Little of no disorientation, tremor, perspiration, hallucinations, convulsions- Majoro Profound disorientation, tremor & profuse perspiration, increased autonomic activity & psychomotor activity, hallucinations, absence of convulsions, possible death from respiratory failure & cardiac arrhythmias 11. Describe fetal alcohol syndrome.- Physical characteristicso Pattern of facial abnormalities including wide set of narrow eyes, smooth ridge on upper lip, thin upper lip bordero Growth defects both prenatally & aftero CNS abnormalities o Can also have Smaller than avg size brains Coordinated problems Abnormal formation of bones & some organs Reduced immunity- Behavioral characteristicso Difficulty in Learning & remembering Understanding & following directions Shifting attention Controlling emotions & impulsivity Communicating & socializing Practicing daily life skills including feeding, bathing, counting money, telling time, minding personal safety - Brain anomalies o Microcephaly o Abnormal corpus callosumCHAPTER 10 1. Describe the spectrum of pharmacological effects of morphine, the prototype opioid analgesic drug. - Behavioral o Sedation o Euphoria Stimulation of dopamine in reward center Initial doses lead to euphoria but higher doses unpleasant
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