Acute Intoxication

Question 1

is methanol toxic?

Answer 1

yes

Question 2

what is methanol present in?

Answer 2

anti-freeze
solvents
contaminated home-brewing

Question 3

products of methanol metabolisation

Answer 3

formaldehyde and then formic acid

Question 4

define methanol toxicity

Answer 4

concentration rising enough to cause acidosis and can lead to blindness

Question 5

treatment for methanol toxicity

Answer 5

ethanol +/- dialysis

Question 6

action of ethanol in methanol toxicity

Answer 6

both metabolised by alcohol dehydrogenase so acts as competitive inhibitor preventing formation of formic acid

Question 7

alcohol recommendations

Answer 7

14 units a week maximum

not to be consumed in 3 continuous days

Question 8

impact of a full stomach on alcohol

Answer 8

slows gastric emptying and prolongs metabolism

Question 9

which drugs increase gastric emptying

Answer 9

antihistamines

metoclopramide

Question 10

do high concentrations of alcohol slow absorption

Answer 10

yes and aerated drinks are absorbed faster

Question 11

reasons males are more tolerant to alcohol

Answer 11

more lean body mass
higher blood volume (even for same weight)
women have less alcohol dehydrogenase

Question 12

alcohol metabolism cascade

Answer 12

alcohol (alcohol dehydrogenase)
acetaldehyde (aldehyde dehydrogenase)
acetate
CO2 + H2O

Question 13

which organs metabolise ethanol?

Answer 13

90% in liver
small intestine
stomach
small amounts in pancreas and brain

Question 14

rate of excretion

Answer 14

15mg/100ml/hour (roughly one unit an hour)

Question 15

when does BAC peak?

Answer 15

about an hour after consumption

Question 16

which ethnic groups have low levels of alcohol dehydrogenase

Answer 16

aborigines
innuits
Asians

Question 17

what does low levels of aldehyde dehydrogenase lead to?

Answer 17

flushing and sickness due to acetaldehyde being toxic

Question 18

what forms the basis of antabuse

Answer 18

acetaldehyde

Question 19

define tolerance (related to ethanol)

Answer 19

up regulation of alcohol dehydrogenase with alternative pathways activated

Question 20

alternative pathways activated in tolerance

Answer 20

1. MEOS (microsomal enzymes oxidase system)
2. catalase
3. CP450s

Question 21

what does the MEOS produce?

Answer 21

lots of H+

Question 22

impact of MEOS system

Answer 22

H+…:

• inhibits gluconeogenesis (hypoglycaemia)
• inhibits Krebs cycle (anaerobic metabolism- lactic acid production)
• impairs fatty acid oxidation (ketogenesis and lipid synthesis = FAT)

Question 23

describe alcohol ketoacidosis

Answer 23

associated with a malnourished state

excess NADH causes impaired fatty acid metabolism and a fasting state results

Question 24

DKA glucose levels

Answer 24

high

Question 25

effects of alcohol

Answer 25

CNS depression
talkativeness
confusion
slurred speech
coordination
consciousness altered (BP and breathing)

Question 26

alcohol effect on ADH

Answer 26

inhibits release reducing water reabsorption

Question 27

hangover sensation

Answer 27

heavy heartbeat due to alcohol being a negative inotrope (HR increases for same CO)

Question 28

define veisalgia cephaligia

Answer 28

headaches associated with a hangover

Question 29

potential cures for a hangover

Answer 29

inhibit prostaglandins

increase metabolism

Question 30

define holiday heart syndrome

Answer 30

binge drinking can cause SVT with spontaneous resolution