Acute Alcohol Intoxication Flashcards

1
Q

is methanol toxic

A

yes

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2
Q

what can methanol poisoning cause

A

blindness

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3
Q

describe the metabolism of methanol

A

metabolised to formaldehyde and then formic acid

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4
Q

treatment of methanol poisoning

A

ethanol +/- dialysis

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5
Q

why do you treat methanol poisoning with ethanol

A

they are both metabolised by alcohol dehydrogenase - ethanol outcompetes methanol and prevents the formation of formic acid

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6
Q

recommended alcohol intake

A

•14units is recommended maximum

Should have several rest days and shouldn’t consume it all in 3 continuous days.

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7
Q

why does drinking on an empty stomach get you drunk quicker

A

the longer the alcohol is in your stomach the slower you get drunk as the more it is metabolised before entering the small bowel, gastric emptying is also slower on a full stomach

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8
Q

what increases gastric emptying and absorption

A

antihistamines and metaclopramides - drunk quicker

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9
Q

are aerated drinks absorbed faster or slower

A

faster

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10
Q

why are spirits absorbed slower

A

irritate gastric mucosa and delay emptying

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11
Q

why do women get drunk quicker

A

have a lower level of alcohol dehydrogenase - don’t eliminate the alcohol. men also have more lean mass fat and higher blood volume so have a bigger pool for dilution

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12
Q

quickest absorption of alcohol

A

•Quickest absorption is at concentrations of 20-30% (not too high) on an empty stomach.

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13
Q

where does 90% of alcohol metabolism occur

A

liver

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14
Q

how much alcohol is excreted via the breath

A

5%

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15
Q

when does alcohol concentration peak after consumption

A

60 min

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16
Q

at what rate is alcohol removed from blood

A

one unit per hour

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17
Q

do some ethnic groups have less alcohol dehydrogenase

A

yes, half japanese people lack it altogether

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18
Q

what enzyme converts ethanol to acetaldehyde

A

alcohol dehydrogenase

19
Q

what converts acetaldehyde to acetate

A

aldehyde dehydrogenase

20
Q

what does alcohol dehydrogenase convert ethanol to

A

acetaldehyde

21
Q

what does aldehyde dehydrogenase convert acetaldehyde to

22
Q

what causes the feeling of flushing or sick

A

defective or inefficient levels of aldehyde dehydrogenase , acetaldehyde is toxic and causes sweating flushing etc

23
Q

what can regular drinking do to levels of alcohol dehydrogenase

A

upregulate them - inc tolerance

24
Q

what pathways are switched on for metabolising alcohol in heavy drinking

A

MEOS, catalase and CP450

  • MEOS uses CO450 enzymes and produces ROS
25
name 3 negative consequences of the use of the MEOS pathway
citric acid cycle inhibition, inhibition of hepatic gluconeogenesis and impairment of fatty acid oxidation
26
what does citric acid cycle inhibition lead to
switch to anaerobic metabolism - more lactic acid produced and sore muscles
27
what does hepatic gluconeogenesis inhibition lead to
munchies, type I diabetics have to watch they dont go into hypoglycaemia
28
what does fatty acid oxidation impairement lead to
* increased Acetyl Co A * increasd fatty acid synthesis and dec fatty acid catabolism * triglyceride acumulation in liver * fat!
29
what induces alcoholic Ketoacidosis
starvation and excess alcohol
30
alcoholic ketoacidosis
* Alcohol diminishes hepatic gluconeogenesis and leads to decreased insulin secretion, increased lipolysis, impaired fatty acid oxidation, and subsequent ketogenesis, causing an elevated anion gap metabolic acidosis. * ketoacidosis without significant hyperglycaemia * presents with nausea, vomiting and abdominal pain
31
what are the physical symptoms of alcoholic ketoacidosis
nausea, vomiting, abdominal pain and death
32
mangement of alcoholic ketoacidosis
* Pabrinex: high dose vitamins * IV fluids (dextrose) * On occasion insulin is required * Address alcohol dependency
33
what effect does alcohol have on the CNS
depression - increases levels of GABA whichb inhibits neurotransmission
34
what effects does alcohol have on the lower brain stem
control of breathing and blood pressure
35
why does alcohol make you pee more
sheer volume of consumption and inhibits ADH which reduces water reabsorption and gives more diluted urine
36
what is the effect of ADH
promotes water reabsorption in the distal tubule and therefore concentrates urine
37
why do you sometimes get a heavy fast heart beat the morning after
alcohol is a negative inotrope - heart beats faster to maintain CO
38
how does holiday heart syndrome usually present
supraventricular tachycardia
39
what is the clinical name for a hangover
veisalgia cephalalgia
40
drinks with high levels of what can cause worse headaches
serotonin and conegeners
41
antabuse action
inhibits aldehyde dehydrogenase - unpleasant reaction to alcohol
42
effects of alcohol by concentration
* \<100 – excitement, fun, disinhibited, still in some control * 100-200 – slurring of speech, blurred vision, falls, wide emotions * \>200 – stupor. Difficult to rouse, loud snoring * Dangerous if brain stem is inhibited – decreased consciousness and breathing
43
how to calculate alcohol units
1 unit = 10ml 100% alcohol eg 70cl 40% = 28 units
44
how does alcohol cause DKA in T1DM
causes decreased insulin secretion etc