Acute Alcohol Intoxication Flashcards
What is an alcohol?
An organic liquid with a hydroxyl group
What is the structure of methanol?
A single carbon wiht a hydroxyl group
What is methanol metabolised to?
Formaldehyde and then formic acid
What are some consequences of digesting methanol?
Toxic acidosis causing blindness and renal failure
How is methanol poisoning treated?
Alcohol +/- dialysis
How does ethanol help in methanol poisoning?
It is a competitve inhibitor of methanol preventing the formation of formic acid
Where is alcohol absorbed?
Manily in the small bowel
What happens to alcohol in the stomach?
It is initially metabolised by alcohol dehydrogenase in the stomach. If there is a stomach full of food, gastric emptying is slowed and therefore alcohol is metabolised for longer
Which drugs can increase gastric emptying?
Antihistamines and metaclopramide
What is the pathway for alcohol metabolism?
Alcohol is metabolised by alcohol dehydrogenase to acetaldehyde. Acetaldehyde is metaboliased to acetate by aldehyde dehydrogenase
What is the rate of alcohol removal in the body?
Removed from the blood at 15mg/100ml/hour
Roughly one unit an hour
What is the mechanism of antabuse (disulfiram)?
It inhibits aldehyde dehydrogenase
What effect does alcohol have on gluconeogenesis?
It inhibits hepatic gluconeogenesis causing hypoglycaemia
What is alcoholic ketoacidosis?
Excess NADH and impaired fatty acid metabolism leading to excess ketogenesis. Results in high ketones with a normal or low glucose level
What effect does alcohol have on the CNS?
It increases the levels of GABBA which is an inhibitor of neurotransmitters
What does alcohol do to the cortex?
Disinhibition
Talkativeness
Anxiolytic
What does alcohol do to the limbic system?
Memory loss
Confusion
Disorientation
What does alcohol do to the cerebellum?
Loss of muscular coordination and slurred speech
What does alcohol do to the reticular formation (upper brain stem)?
Loss of consciousness
What does alcohol do to the lower brain stem?
Control of breathing and BP
What effect does alcohol have on ADH levels?
Inhibits ADH causing water reabsorption and clearer urine (ADH promotes water absorption in the distal tubule)
What is holiday heart syndrome?
Heavy binge drinking can cause SVT with spontaneous resolution
