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

- The more you drink alcohol the more Mixed function oxidation metabolism activity increases. You gain a tolerance since there is more metabolism of alcohol and you need to drink more to gain an CNS effect.

- Alcohol potentiates the GABA Complex receptor. The more CNS stimulation you have the more the body will compensate for the hyper-activity. Downregulation of the GABA complex receptor will take place and you will need more alcohol for a CNS effect. This being said other symptoms of alcohol will need more alcohol concentration to trigger the symptoms = tolerance.

I think also hypnotic – sedative drugs can play a roll in alcohol tolerance. Benzodiazepines (BDs) also work on the GABA complex receptor. Some people use BDs chronically and can also cause downregulation of receptors. Since Alcohol and BDs work on the same receptor more of both substances is needed for a CNS effect = tolerance.

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

Chronic alcohol consumption lowers the liver function and can lead to hepatitis and liver cirrhosis. The liver has various functions in the body which is also being reduced with chronic alcohol consumption.  Gluconeogenesis processes are being delayed and leads to hypoglycaemia (<3.9 mmol/L).

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

Wernicke-Korsakoff syndrome is a type of brain disorder caused by lack of Vit-B or Thiamine (Healthline, 2018). The main cause of this syndrome is due to alcohol misuse. It is being treated by giving a patient oral thiamine or vitamin B.

• Fully explain the foetal alcohol syndrome.

Foetal alcohol syndrome is when a pregnant mother misuse alcohol. Alcohol has a teratogenic affect. It causes mental retardation where the brain does not grow as it should There is a growth deficiency and causes atrophy. Its usually during alcohol abuse during the first trimester.

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

Chronic alcohol consumption increases metabolic transformation of other drugs.  Where acute alcohol consumption lowers metabolism of drugs.

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

Phenothiazines, Anti-Depressent drugs, sedative hypnotic drugs and aspirin. It also can have an effect on paracetamol where more NAPQI is being produced that could cause liver toxicity.

Reference :

Bertram G. Katzung 2018, B Basic & Clinical Pharmacolog, Lange, McGraw hill, University of California, San Francisco