Alcohol absorption, distribution, elimination, and effects

• Author: Don Bartell/Mary Catherine McMurray/Anne ImObersteg
• Pages: 49-76

2-1

CHAPTER 2

ALCOHOL ABSORPTION,

DISTRIBUTION,

ELIMINATION, AND

EFFECTS

I. PHARMACOLOGY AND TOXICOLOGY OF ALCOHOL

§2:01 Two Subsets Describe Metabolism

§2:02 Pharmacokinetics

§2:03 Pharmacodynamics

II. PHARMACOKINETICS

A. General Points

§2:10 Circulation Through the Blood Stream

§2:11 Graph of Blood Alcohol Concentration Over Time

B. Absorption

1. Methods of Absorption

§2:20 Primary Method of Absorption

§2:21 Other Methods of Absorption

2. Factors That Affect Absorption

a. Common Factors

§2:30 General Points

§2:31 Food

§2:32 Speed of Ingestion of Alcohol

§2:33 Cigarette Smoking

§2:34 Type and Strength of Alcohol

§2:35 Gender

§2:36 Stomach Diseases

§2:37 Physiological State of the Subject

§2:38 Age

ALCOHOL ABSORPTION,

DISTRIBUTION,

ELIMINATION, AND EFFECTS

Attacking and Defending Drunk Driving Tests 2-2

ALCOHOL ABSORPTION,

DISTRIBUTION,

ELIMINATION, AND EFFECTS

b. Drugs

§2:40 Glycine, Glycylglycine, Glycylglycylglycine and Alanine

§2:41 First-Pass Metabolism: Ibuprofen, Ranitidine, Cimetidine, and Aspirin

§2:42 Cholinergic and Adrenergic Drugs

C. Distribution

§2:50 General Distribution System

§2:51 Volume of Distribution: V(d)

§2:52 Arterial vs. Venous Concentration During Absorption and Distribution

§2:53 Distribution in the Body Tissues and Fluids

D. Elimination

1. General Points

§2:60 Elimination by Oxidation

§2:60.1 How Oxidation Works

§2:61 Average Elimination Rates

2. Metabolism Kinetics

§2:70 Three Enzyme Systems for Oxidation

§2:71 Alcohol Dehydrogenase (ADH)

§2:72 The Microsomal Alcohol-Oxidizing System (MEOS)

§2:73 The Catalase System

3. Elimination Kinetics

§2:80 The Widmark Hypothesis

§2:81 The Michaelis-Menten Model

4. Factors That Affect Elimination

§2:90 General Points

§2:91 Food in the Stomach

§2:92 Racial Genetics

§2:93 Fructose

§2:94 Age and Sex

§2:95 Chronic Alcoholism

§2:96 Pathological Factors: Disease

E. Estimating Peak Alcohol Concentration

1. Normal Patterns

§2:100 Over-Simplif‌ication Is a Hazard to Estimating

§2:101 Conservative Estimates Are Statistically More Accurate

§2:102 BA Levels Can Change or Plateau

2. Anomalies in BA Concentrations

§2:110 Curve May Fluctuate

§2:111 “Zig-Zag” Effect

§2:112 Inter- and Intra-Subject Variation

III. PHARMACODYNAMICS

A. General Points

§2:120 Drugs Alter Normal Functions

§2:121 Distinction Between Effects and Impairment

§2:122 Response to Effects May Vary

B. Effects of Alcohol

§2:130 Alcohol Affects Many Body Sites

§2:131 BAC vs. Effects Charts

§2:132 Effects Are Progressive and Cumulative

§2:133 Effects on the Brain

§2:134 Impairment Does Not Correlate With BAL

§2:135 Blackouts

C. Factors That Affect Level of Impairment

§2:140 Many Factors Affect Impairment