Lesson 1Short-term physiological effects: central nervous system, motor function, sleep, and acute intoxicationCovers immediate effects of alcohol on the brain, behaviour, and body. Looks at dose-related brain slowdown, movement and thinking problems, sleep disturbances, sudden intoxication issues, and factors influencing quick responses.
Dose-response and blood alcohol levelsCNS depression and neurochemical changesMotor incoordination and reaction timeEffects on sleep architecture and qualityClinical features of acute intoxicationRisk factors for accidents and injuriesLesson 2Long-term effects on mental health: depression, anxiety, suicidality, and interaction with psychiatric medicationsExplores how ongoing alcohol use impacts mental well-being, leading to depression, anxiety, suicide thoughts, and relapse. Discusses two-way links, diagnosis difficulties, and interactions with mental health medicines and treatments.
Alcohol and depressive disordersAnxiety, panic, and alcohol useSuicidal ideation and attempt riskDiagnostic overlap and masking effectsInteractions with antidepressants and mood stabilizersIntegrated treatment and relapse preventionLesson 3Long-term organ-specific effects: brain (cognitive impairment, Wernicke-Korsakoff), neuroadaptation and dependenceFocuses on lasting alcohol effects on the brain, including thinking decline, Wernicke-Korsakoff condition, and structural changes. Explains brain adaptation, tolerance, dependence, and connections to clinical checks and prevention.
Cognitive impairment and dementia riskThiamine deficiency and Wernicke-KorsakoffStructural and functional brain changesMechanisms of tolerance and sensitisationNeural circuits of dependence and cravingScreening and neurocognitive assessmentLesson 4Metabolism and elimination: alcohol dehydrogenase, CYP2E1, acetaldehyde, first-pass metabolism, elimination kineticsDetails enzyme pathways that remove ethanol, including alcohol dehydrogenase, CYP2E1, and catalase. Explains acetaldehyde harm, first-pass metabolism, zero-order kinetics, genetic differences, and how illnesses and drugs change clearance.
Alcohol dehydrogenase pathwaysCYP2E1 induction and toxic byproductsAcetaldehyde formation and detoxificationFirst-pass metabolism and gut-liver axisZero-order kinetics and clinical implicationsGenetic polymorphisms affecting metabolismLesson 5Distribution of alcohol: blood alcohol concentration, body water, sex and age differencesExplains how ethanol spreads in body water, how blood alcohol concentration is calculated, and how sex, age, body build, and pregnancy affect levels. Introduces Widmark ideas and effects on testing and dosing.
Volume of distribution and body waterWidmark formula and BAC estimationSex differences in BAC and effectsAge-related pharmacokinetic changesImpact of obesity and body compositionPregnancy and lactation considerationsLesson 6Interactions with common comorbidities and medications (antihypertensives, diabetes medications, psychotropics)Reviews how alcohol interacts with common long-term illnesses and medicines, including blood pressure drugs, diabetes treatments, and mental health meds. Discusses body and drug effect interactions and ways to manage clinically.
Effects on blood pressure and heart drugsInteractions with diabetes medicationsAlcohol and psychotropic drug synergyHepatic metabolism and drug levelsAlcohol in chronic pain and opioidsCounseling patients on safe useLesson 7Ethanol absorption: oral intake, gastric emptying, and factors affecting rateExamines how ethanol is taken in after drinking, including stomach and small intestine stages. Discusses stomach emptying, food effects, drink strength, and other factors that change absorption speed and peak blood alcohol.
Sites and mechanisms of ethanol absorptionRole of gastric emptying and motilityInfluence of food and meal compositionBeverage concentration and carbonationEffects of GI disease and surgeryPractical ways to slow absorptionLesson 8Alcohol withdrawal physiology and risk factors for severe withdrawal (delirium tremens, seizures)Describes the brain biology of alcohol withdrawal, from mild signs to delirium tremens and fits. Reviews receptor changes, body overdrive, risks for severe withdrawal, and ways to assess clinical risks.
Neuroadaptation of GABA and glutamateAutonomic hyperactivity mechanismsClinical spectrum of withdrawal signsPathophysiology of seizures and DTsRisk factors for complicated withdrawalAssessment tools and risk stratificationLesson 9Long-term organ-specific effects: liver (steatosis, hepatitis, cirrhosis) and pathophysiologyExplores how regular alcohol use harms the liver, from fat buildup to inflammation and scarring. Reviews cell damage, scarring paths, signs, and how amount, drinking pattern, and other illnesses affect disease risk.
Progression from steatosis to cirrhosisHepatocellular injury and oxidative stressInflammation, fibrosis, and stellate cellsClinical features and diagnostic evaluationImpact of nutrition, obesity, and viral hepatitisLesson 10Long-term organ-specific effects: cardiovascular system (hypertension, cardiomyopathy, arrhythmia)Analyses lasting heart and blood vessel effects of alcohol, including high blood pressure, heart muscle weakness, and irregular beats. Reviews dose-response info, damage mechanisms, presentations, and advice for risk talks.
Blood pressure changes and mechanismsAlcoholic cardiomyopathy pathophysiologyArrhythmias, including atrial fibrillationInteractions with cardiovascular drugsReversibility with abstinence or reductionRisk communication and patient advice
