Acute Intoxication Flashcards
is methanol toxic?
yes
what is methanol present in?
anti-freeze
solvents
contaminated home-brewing
products of methanol metabolisation
formaldehyde and then formic acid
define methanol toxicity
concentration rising enough to cause acidosis and can lead to blindness
treatment for methanol toxicity
ethanol +/- dialysis
action of ethanol in methanol toxicity
both metabolised by alcohol dehydrogenase so acts as competitive inhibitor preventing formation of formic acid
alcohol recommendations
14 units a week maximum
not to be consumed in 3 continuous days
impact of a full stomach on alcohol
slows gastric emptying and prolongs metabolism
which drugs increase gastric emptying
antihistamines
metoclopramide
do high concentrations of alcohol slow absorption
yes and aerated drinks are absorbed faster
reasons males are more tolerant to alcohol
more lean body mass
higher blood volume (even for same weight)
women have less alcohol dehydrogenase
alcohol metabolism cascade
alcohol (alcohol dehydrogenase)
acetaldehyde (aldehyde dehydrogenase)
acetate
CO2 + H2O
which organs metabolise ethanol?
90% in liver
small intestine
stomach
small amounts in pancreas and brain
rate of excretion
15mg/100ml/hour (roughly one unit an hour)
when does BAC peak?
about an hour after consumption
which ethnic groups have low levels of alcohol dehydrogenase
aborigines
innuits
Asians
what does low levels of aldehyde dehydrogenase lead to?
flushing and sickness due to acetaldehyde being toxic
what forms the basis of antabuse
acetaldehyde
define tolerance (related to ethanol)
up regulation of alcohol dehydrogenase with alternative pathways activated
alternative pathways activated in tolerance
- MEOS (microsomal enzymes oxidase system)
- catalase
- CP450s
what does the MEOS produce?
lots of H+
impact of MEOS system
H+…:
- inhibits gluconeogenesis (hypoglycaemia)
- inhibits Krebs cycle (anaerobic metabolism- lactic acid production)
- impairs fatty acid oxidation (ketogenesis and lipid synthesis = FAT)
describe alcohol ketoacidosis
associated with a malnourished state
excess NADH causes impaired fatty acid metabolism and a fasting state results
DKA glucose levels
high
effects of alcohol
CNS depression talkativeness confusion slurred speech coordination consciousness altered (BP and breathing)
alcohol effect on ADH
inhibits release reducing water reabsorption
hangover sensation
heavy heartbeat due to alcohol being a negative inotrope (HR increases for same CO)
define veisalgia cephaligia
headaches associated with a hangover
potential cures for a hangover
inhibit prostaglandins
increase metabolism
define holiday heart syndrome
binge drinking can cause SVT with spontaneous resolution
