Acute Alcohol Intoxication Flashcards

1
Q

What is methanol found in?

A

Anti-freeze, solvents and some home brews

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2
Q

What is methanol metabolised to ?

A

Formaldehyde then formic acid

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3
Q

What can methanol acidosis lead to?

A

Blindness

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4
Q

Why is methanol poisoning treated with alcohol?

A

Competitive inhibition-both are metabolised by alcohol dehydrogenase

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5
Q

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

A

6 units

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6
Q

Where is alcohol mainly absorbed?

A

Small intestines

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7
Q

Why does a full stomach slow the effects of alcohol?

A

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

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8
Q

Give examples of substances that increase gastric emptying?

A

Anti-histamines and metoclopramide

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9
Q

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

A

Spirits irritate the gastric mucosa and delay emptying

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10
Q

What percentage of alcohol has the quickest absorption?

A

20-30% (e.g sherry)

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11
Q

Why are women more affected by alcohol than men?

A

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

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12
Q

What enzyme metabolises alcohol to acetaldehyde?

A

Alcohol dehydrogenase

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13
Q

What enzyme metabolises acetaldehyde to acetate?

A

Aldehyde dehydrogenase

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14
Q

What are the final products of alcohol metabolism?

A

CO2 and H2O

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15
Q

Where does alcohol metabolism take place?

A

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

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16
Q

How much alcohol is excreted through the breath?

A

5%

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17
Q

What rate is alcohol removed from the blood?

A

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

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18
Q

After how long does alcohol concentration peak?

A

Around 60 mins after consumption

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19
Q

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

A

Aboriginies, Eskimos, Inuits

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20
Q

What percentage of Japanese people lack alcohol dehydrogenase?

A

50%

21
Q

Why do SE Asians experience “Asian flushing”?

A

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

22
Q

What is Antabuse?

A

A drug that inhibits aldehyde dehydrogenase which makes drinking unpleasant

23
Q

Name two alternative pathways utilised by heavy drinkers

A

MEOS pathway and Catalase pathway

24
Q

What are the dangers of the MEOS pathway?

A

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

25
Q

What happens when the Krebs cycle is inhibited?

A

Switches to anaerobic metabolism so more likely to produce lactic acid

26
Q

What happens when hepatic gluconeogenesis is inhibited?

A

Blood glucose becomes low

27
Q

What happens when fatty acid oxidation is inhibited?

A

Excess ketogenesis and lipid synthesis

28
Q

What state is alcoholic ketoacidosis associated with?

A

Malnourished state

29
Q

What happens in alcoholic ketoacidosis?

A

Excess NADH and impaired fatty acid metabolism so fasting state results

30
Q

What are the glucose levels like in alcoholic ketoacidosis?

A

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

31
Q

What effect does alcohol have on the CNS?

A

CNS depressant-increases levels of GABBA

32
Q

What is GABBA?

A

An inhibitor of neurotransmitters

33
Q

What effects does alcohol have on the cortex?

A

Disinhibition, anxiolytic, talkativeness

34
Q

What effects does alcohol have on the limbic system?

A

Memory loss, confusion

35
Q

What effects does alcohol have on the cerebellum?

A

Loss of muscular co-ordination

36
Q

What does the reticular formation of the brain control?

A

Consciousness

37
Q

What is the lower brain stem involved in?

A

Control of breathing

38
Q

What are the effects of alcohol levels <100?

A

Excitement, fun, still in control

39
Q

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

A

Slurring, blurred vision, falling over

40
Q

What are the effects of alcohol levels >200?

A

Stupor, loud snoring, difficult to rouse

41
Q

What does ADH do?

A

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

42
Q

What does alcohol do to ADH?

A

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

43
Q

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

A

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

44
Q

What are some features of holiday heart syndrome?

A

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

45
Q

What is the headache of a hangover known as?

A

Veisalgia Cephalia

46
Q

What are congeners?

A

Things added to contribute to the smell of alcohol

47
Q

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

A

Serotonin (produced from sulphites, tannins and phenols)

48
Q

Which fruits can make a headache worse?

A

Bananas and pineapples

49
Q

How could you cure a hangover?

A

Inhibit prostaglandins and speed up metabolism