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

Tolerance to alcohol might result from ethanol-induced up-regulation of the MEOS pathway in response to continuous presence of ethanol in the system. This means that more alcohol is metabolized per unit time, which results in a higher tolerance. 

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

Alcohol abuse causes progressive liver function decline. This can lead to alcoholic hepatitis, liver cirrhosis and liver failure. Gluconeogenesis decreases which leads to hypoglycaemia. There is dysregulation of Fatty Acid oxidation and synthesis which leads to fat accumulation. 

The MEOS system is also upregulated which results in increased metabolism of other drugs. 

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

Wernicke-Korsakoff syndrome is an uncommon syndrome characterized by neurological damage, ataxia, paralysis of the facial muscles, confused state that can develop to coma/death. 

This syndrome is associated with Thiamine deficiency and therefore can be treated with parenteral Thiamine.  

Fully explain the foetal alcohol syndrome.

Foetal alcohol syndrome is the result of chronic maternal alcohol abuse during the 1^st trimester of pregnancy. Alcohol is associated with teratogenic effects, and crosses the placenta, to reach concentrations in the fetus that are similar to those in the mother. Since the fetus’ liver has little to no alcohol dehydrogenase enzymes, it relies on the mother and placental enzymes for elimination of alcohol. 

Children that are exposed to ethanol while in utero may have a wide range of developmental disabilities, cognitive and behavioural deficits that stem from damage to developing neurons. 

Developmental disabilities include: mental retardation, attention deficit disorders, perceptual problems, memory and learning disabilities, and psychomotor dysfunction. 

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

Chronic alcohol abuse increases the metabolism of drugs, while acute alcohol abuse decreases the metabolism of drugs. 

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

• paracetamol,
• aspirin,
• vasodilators,
• Benzodiazepines