Acute Alcohol Intoxication

Question 1

What is methanol found in?

Answer 1

Anti-freeze, solvents and some home brews

Question 2

What is methanol metabolised to ?

Answer 2

Formaldehyde then formic acid

Question 3

What can methanol acidosis lead to?

Answer 3

Blindness

Question 4

Why is methanol poisoning treated with alcohol?

Answer 4

Competitive inhibition-both are metabolised by alcohol dehydrogenase

Question 5

How many units of alcohol cause the liver to become fatty?

Answer 5

6 units

Question 6

Where is alcohol mainly absorbed?

Answer 6

Small intestines

Question 7

Why does a full stomach slow the effects of alcohol?

Answer 7

A full stomach slows gastric emptying which means more alcohol is metabolised in the stomach before moving into the small intestines

Question 8

Give examples of substances that increase gastric emptying?

Answer 8

Anti-histamines and metoclopramide

Question 9

Why are spirits and other drinks with high alcohol contents absorbed slower?

Answer 9

Spirits irritate the gastric mucosa and delay emptying

Question 10

What percentage of alcohol has the quickest absorption?

Answer 10

20-30% (e.g sherry)

Question 11

Why are women more affected by alcohol than men?

Answer 11

Women have a higher mass of subcutaneous fat percentage and a lower pool for dilution; women also have lower levels of alcohol dehydrogenase

Question 12

What enzyme metabolises alcohol to acetaldehyde?

Answer 12

Alcohol dehydrogenase

Question 13

What enzyme metabolises acetaldehyde to acetate?

Answer 13

Aldehyde dehydrogenase

Question 14

What are the final products of alcohol metabolism?

Answer 14

CO2 and H2O

Question 15

Where does alcohol metabolism take place?

Answer 15

90% occurs in liver; small volume in pancreas and breath

Question 16

How much alcohol is excreted through the breath?

Answer 16

5%

Question 17

What rate is alcohol removed from the blood?

Answer 17

15mg/100ml/hr (roughly 1 unit/hr)

Question 18

After how long does alcohol concentration peak?

Answer 18

Around 60 mins after consumption

Question 19

Name some ethnicities that have low/absent levels of alcohol dehydrogenase (or aldehyde dehydrogenase)

Answer 19

Aboriginies, Eskimos, Inuits

Question 20

What percentage of Japanese people lack alcohol dehydrogenase?

Answer 20

50%

Question 21

Why do SE Asians experience “Asian flushing”?

Answer 21

They have a deficient/ineffective variant of aldehyde dehydrogenase so acetaldehyde is not metabolised properly

Question 22

What is Antabuse?

Answer 22

A drug that inhibits aldehyde dehydrogenase which makes drinking unpleasant

Question 23

Name two alternative pathways utilised by heavy drinkers

Answer 23

MEOS pathway and Catalase pathway

Question 24

What are the dangers of the MEOS pathway?

Answer 24

It produces hydrogen ions which inhibits hepatic gluconeogenesis, the Krebs cycle and fatty acid oxidation

Question 25

What happens when the Krebs cycle is inhibited?

Answer 25

Switches to anaerobic metabolism so more likely to produce lactic acid

Question 26

What happens when hepatic gluconeogenesis is inhibited?

Answer 26

Blood glucose becomes low

Question 27

What happens when fatty acid oxidation is inhibited?

Answer 27

Excess ketogenesis and lipid synthesis

Question 28

What state is alcoholic ketoacidosis associated with?

Answer 28

Malnourished state

Question 29

What happens in alcoholic ketoacidosis?

Answer 29

Excess NADH and impaired fatty acid metabolism so fasting state results

Question 30

What are the glucose levels like in alcoholic ketoacidosis?

Answer 30

Low or normal glucose with high ketones (usually beta-hydroxybutyrate)

Question 31

What effect does alcohol have on the CNS?

Answer 31

CNS depressant-increases levels of GABBA

Question 32

What is GABBA?

Answer 32

An inhibitor of neurotransmitters

Question 33

What effects does alcohol have on the cortex?

Answer 33

Disinhibition, anxiolytic, talkativeness

Question 34

What effects does alcohol have on the limbic system?

Answer 34

Memory loss, confusion

Question 35

What effects does alcohol have on the cerebellum?

Answer 35

Loss of muscular co-ordination

Question 36

What does the reticular formation of the brain control?

Answer 36

Consciousness

Question 37

What is the lower brain stem involved in?

Answer 37

Control of breathing

Question 38

What are the effects of alcohol levels <100?

Answer 38

Excitement, fun, still in control

Question 39

What are the effects of alcohol levels between 100-200?

Answer 39

Slurring, blurred vision, falling over

Question 40

What are the effects of alcohol levels >200?

Answer 40

Stupor, loud snoring, difficult to rouse

Question 41

What does ADH do?

Answer 41

Promotes water reabsorption in the distal tubule of the kidneys and concentrates urine

Question 42

What does alcohol do to ADH?

Answer 42

Directly inhibits it so reduces water reabsorption and dilutes urine (makes you pee more)

Question 43

Why does alcohol give the sensation of a heavy heart beat?

Answer 43

Alcohol is a negative inotrope (reduces contractility)-heart has to beat faster to maintain CO

Question 44

What are some features of holiday heart syndrome?

Answer 44

Linked with binge drinking, otherwise healthy heart, supraventricular tachycardia, spontaneous resolution

Question 45

What is the headache of a hangover known as?

Answer 45

Veisalgia Cephalia

Question 46

What are congeners?

Answer 46

Things added to contribute to the smell of alcohol

Question 47

What substance that contributes to a headache are found in red wine?

Answer 47

Serotonin (produced from sulphites, tannins and phenols)

Question 48

Which fruits can make a headache worse?

Answer 48

Bananas and pineapples

Question 49

How could you cure a hangover?

Answer 49

Inhibit prostaglandins and speed up metabolism