A LCOHOL A DDICTION AND T HE T REATMENT OF A LCOHOL A BUSE WITH
D ISULFIRAM By: Chvez, Jessica Coffey, Alisha Folkes, Lennora
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A LCOHOL
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E THANOL M ETABOLISM Lieber, C. 2004 CH 3 CHOCH 3 COOHCH 3
CO-S-CoA Acetaldehyde DHAcetyl-CoA Synthase
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A LCOHOL A DDICTION What is it? Compulsive need for an
intoxicating liquid. Beer, wine, liquor, etc. Cannot limit or
contain his or her drinking. Desire to drink great amount of
alcohol in order to feel a high Suppresses the ability to stop
drinking Feeling of wanting to drink in order to relax or feel
better Relying on alcohol to function and physically compelled to
drink.
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A DDICTION When Alcohol is consumed endorphins, the bodys
natural opiates, are released. Endorphins bind to the receptor
sites in the brain and result in the feeling of pleasure when
consuming alcohol. Alcoholics and their family members have reduced
plasma levels of -Endorphins which means they are more prone to
becoming alcoholics because of the pleasure caused by consuming
alcohol. o The dopaminergic pathway from the ventral tegmental area
(VTA) to the nucleus accumbens mediates stimulatory and positive
reinforcing properties of alcohol. Clapp, et. al. 2008
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D IFFERENT L OOK I NSIDE A LCOHOL E FFECTS IN N EURONS Clapp,
et. al. 2008
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A LCOHOL E FFECTS IN THE L IVER Fatty liver -Steatosis- is the
collection of excessive amounts of fats and triglycerides. Fat
metabolism or the production of energy is disturbed by alcohol
causing fat to not break down properly. Fat vacuoles form growing
larger as drinking increases, soon fat vacuoles coalesce to form
cysts Once cysts form, liver cells are damaged for good.
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L IVER D AMAGE FROM A LCOHOL A BUSE
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D ISULFIRAM
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DISULFIRAM : W HAT IS IT ? Chemical name: tetraethylthiuram
disulfide [TETD] Brand name: Antabuse Drug used to treat chronic
Alcoholism. Causes unpleasant side effects when small amounts of
alcohol is consumed. The rationale behind the use of the drug is to
induce fear in the patient of the consequences of ingesting alcohol
and to reinforce abstinence. The punishment for drinking alcohol
while taking the medication results in the disulfiram-ethanol
reaction (DER). The drug should not be taken if allergic to thiuram
or thiuram-related chemicals.
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S YMPTOMS OF D ISULFIRAM Less Serious Side Effects: Face/body
flushing Skin rash Drowsiness Throbbing Headache Metallic or
garlic-like taste in the mouth Impotence Swollen or sore tongue
Nausea/vomiting Side Effects That Require Medical Attention
Immediately: Dark urine Extreme Fatigue Loss of appetite Upset
stomach Yellowness of the skin or eyes Severe Diarrhea and Vomiting
Seizures Shortness of Breath Allergic Reaction (Swelling of lips,
tongue, or face) The Side Effects the Medication Causes:
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R OLE OF D ISULFIRAM IN E THANOL M ETABOLISM Ethanol
Acetaldehyde Acetate Acetyl CoA Disulfiram Disulfiram:
Irreversively inhibit ALDH Reduces Oxidation of acetaldehyde
Accumulation of acetaldehyde causes unpleasant side effects.
Alcohol DH Acetaldehyde DH Acetyl CoA Synthase
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D ISULFIRAM -E THANOL R EACTION (DER) Disulfiram blocks the
enzyme Acetaldehyde Dehydrogenase (ALDH). The symptoms are due to
an increase of serum acetaldehyde concentrations. Discomforts
associated with the syndrome are intended to serve as a negative
stimulus; however, the reaction may be severe enough to cause
hypotension and death if a high dose is taken.
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Gaval cruz et. al. 2009
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Vicari, Katie et al 2010
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C ONCLUSION o Ethanol is broken down by the body in several
different ways that all end with acetaldehyde o Alcohol can cause
fatty acids and triglycerides to accumulate in the liver and if
left untreated can cause Fatty Liver, Hepatitis, and eventually
Cirrhosis o Alcohol abuse effects not only the liver, but the
sympathetic nervous system as well o Disulfiram is a treatment for
people who abuse alcohol by using negative reinforcement
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REFERENCES Clapp, Peter, Bhave, Sanjiv V., Hoffman, Paula L.
(2008) How Adaptations of the Brain to Alcohol Leads to Dependence.
National Institute on Alcohol Abuse and Alcoholism.
http://pubs.niaaa.nih.gov/publications/arh314/310-339.htm
Gaval-Cruz, M. and Weinshenker, D. (2009). Mechanisms of
Disulfarim-Induced Cocaine Abstinence Antabuse and Cocaine Relapse.
Molecular Intervention. 9(4), 135-187. Fairbanks, Krysten D.
Alcoholic Liver Disease. The Cleveland Clinic Foundation. Retrieved
by http://www.clevelandclinicmeded.com/medicalpubs/diseasema
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Dictionary by Farlex. Retrieved by http://medical-
dictionary.thefreedictionary.com/Hepatic+steatosis Kitson, Trevor,
M. (1977) The Disulfiram-Ethanol Reaction. Journal of Studies on
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Alcoholic fatty liver: its pathogenesis and mechanism of
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