Alchohol - French Flashcards
At what rate is alcohol metabolized?
7-10 grams/hour. (Coors light has 12,000 mg = 12g).
Results in a 0.015 - 0.020 decrease in BAC/hr.
What is the elimination kinetics of EtOH?
Zero order. (Once the enzyme pathways are saturated, it proceeds at a constant rate, regardless of the amount ingested/BAC)
What is the primary metabolic pathway for EtOH? Where is it located, and what are the enzymes involved. What is the end product?
What other metabolites are formed?
Alchohol dehydrogenase in the liver is responsible for the majority of metabolism.
EtOH–dehydrogenase–> Acetaldehyde –> Acetic acid
Also see INcrease in NADH and LACTATE
At higher BAC (0.05 - 0.18), what enzyme system kicks in?
CYP2E1. Metabolizes 10-25% at high BAC.
On what enzyme does disulfiram act?
What are the effects?
Inhibits acetaldehyde dehydrogenase, which normally converts acetaldehyde–> acetic acid. This is the same enzyme missing in some asians.
Buildup of acetaldehyde causes orthostatic hypotension, flushing, nausea, headache.
Women generally have higher body fat percentages than men. Why does this make their BAC higher for a given amt of alcohol (assume same kg mass)?
EtOH distributes in water. Fat contains little water, so the concentration in the blood/plasma ends up being higher.
What does a brethalyzer measure?
0.05% of the BAC is exhaled as EtOH, unmetabolized.
What is the effect of EtOH on GABA/Glu neurons?
A CNS depressant, so
facilitate GABA
inhibit Glu-NDMA
Which reaction, alcohol dehydrogenase or acetaldehyde dehydrogenase, reduces NAD to NADH?
Both.
What are some effects of NADH buildup (eg failure to regenerate NAD)
1) increased blood lactate–> acidosis
2) increased Mg secretion–> convulsions
3) increased Acetyl CoA–> increase fatty acid synthesis and decrease fat breakdown = fatty liver
4) Increase NADH–> hypoglycemia (stop krebs, stop gluconeogenesis.
5) Decrease uric acid excretion–> gout attack
What causes pancreatitis in heavy drinkers?
Increased digestive secretions.
What are long-term effects of drinking on the liver?
Fatty change–> collagen deposition–> cirrhosis –> increased venous pressure leads to esophageal varicosities, ascites, increased bleed time due to clotting factor decrease.
What are some features of Alcohol Withdrawal Syndrome (AWS)? At what time (hours) does each typically occur?
Seizures (6-48 hours) Visual hallucination (12-48 hours) Delirium tremens (48-96 hours)
In mild withdrawal, see anxiety, restlessness, tremor, etc.
A patient presents with no medical history, exhibiting external ophthalmoplegia, nystagmus, ataxia of gait, pain, loss of sensation, and weakness of the arms and legs.
Treat with?
Thiamine. B1
Wernicke’s encephalopathy
Response is good, most patients recover fully.
What differentiates Korsakoffs psychosis from Wernickes?
Symptoms of Korsakoffs include severe amnesia and personality alterations.
Irreversible.
