What are the possible mechanisms involved in the occurrence of tolerance to chronic alcohol intake?

• The MEOS (mixed function oxidases) activity is increased with the chronic use of alcohol. This system can be induced, and is also partially responsible for tolerance when it comes to alcohol intake. When there is chronic use of alcohol, it would also cause there to be more alcohol used to get the same effects, because the receptor undergoes sub-sensitivity.

What are the toxic effects of chronic alcohol consumption on the liver and hepatic metabolism?

• In the liver it would cause a progressive decrease in liver function, hepatitis and cirrhosis of the liver. This is worse in women than in men. Gluconeogenesis also decreases, hypoglycemia, fat accumulation, nutrient deficiencies all contribute to this. The toxic effects also cause and increase in the activity of liver microsomal enzymes.

What is Wernicke-Korsakoff-syndrome and how is it treated?

• Wernicke-Korsakoff syndrome is neurological damage that is normally caused by a thiamine deficiency. It is treated by administration of Thiamine.

Fully explain the foetal alcohol syndrome.

• FAS is when babies are exposed to alcohol during the first trimester or during pregnancy, this causes birth defects in a child. Mental retardation, ADD, perceptual problems , memory and learning disabilities, and psychomotor dysfunction can all be seen in children who suffer from FAS. When the mother drinks alcohol during the pregnancy this causes damage to a child’s neurons and this is what tends to be the cause of these children’s mental and behavioural disabilities.

How do the pharmacokinetic interactions of acute alcohol consumption differ from that of chronic alcohol consumption?

• Acute alcohol use shows a decrease in the metabolism of drugs like, Phenothiazines, TAD’s and other sedative hypnotics.
• Chronic alcohol use increases the metabolic transformation of other drugs like Paracetamol.

Name 4 drug interactions with alcohol where the pharmacological effects of the other drugs are potentiated by alcohol.

• TAD’s and sedative hypnotics will supress the CNS further.
• Paracetamol will induce CYP2E1 – which can produce a toxic metabolite.
• Aspirin will have an increase anti-platelet aggregation effects.
• Vasodilators and Hypoglycemic drugs effects are potentiated.