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

Chronic alcohol intake may result in tolerance and physical or psychological dependence. This may occur due to several mechanisms. This takes place through changes in the central nervous system adjustment due to constant exposure on receptors or secondary messengers as well as an increase in the rate of alcohol metabolism induced by the MEOS when chronic alcohol consumption occurs allowing for increased metabolism of ethanol and clearance of other drugs in the body that are eliminated by CYP450 enzymes.

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

Liver diseases such as Hepatitis, Cirrhosis and Liver failure may all result from the progressive decrease in liver function caused by chronic alcohol use. This tissue damage results from the direct effects of ethanol and acetaldehyde and having to process an increased load of active metabolites. The decrease in gluconeogenesis causes hypoglycaemia and fat accumulation, also nutrient deficiencies may contribute to the damage.

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

A unique syndrome that occurs because of neuropathy. It is characterized by paralysis of external eye muscles, ataxia and confusion which may lead to coma and death. This syndrome is associated with a thiamine(B1) deficiency therefore patients with chronic alcohol effects are administered thiamine therapy parenterally to prevent any permanent brain damage.

• Fully explain the foetal alcohol syndrome.

Foetal alcohol syndrome is caused by the alcohol abuse of a mother while pregnant due to the ethanol consumed by the mother crossing the placenta and thus resulting in the foetus having the same alcohol blood concentration as the mother. Mental retardations and underdevelopment of the facial area are commonly seen in infants that has this syndrome and this syndrome usually has teratogenic effects.

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

Acute – the alcohol dehydrogenase enzyme plays a role with low to moderate levels of alcohol consumption which catalyses the conversion of alcohol to acetaldehyde.

Chronic- on the other hand the MEOS plays a role with the consumption of high concentrations alcohol as their activity gets induced by the chronic consumption of alcohol.

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

it has an interaction on vasodilators, sedatives and hypnotics, hypoglycaemic drugs and Aspirin where it will increase the platelet adhesion