Alcohol Flashcards
Current recs for alcohol
women vs men vs absolute max
- avoid if (3)
- women: max 1 drink per day
- men: 1-2 drinks per day
- max 4 on any occasion + drink with food
- pregnant, operating machinery, can’t control intake
Updates on recs
- rec?
- 3-6/week = ?
- >7/week = ?
- max 2 drinks per week for everyone
- 3-6 drinks/week –> increase cancer risk
- > 7drinks/week = increase heart disease and stroke risks
Alcohol acts as a ___________ and ____________ in brain –> ?
narcotic sedative and depressant
- sedates inhibitory nerves
effects of alcohol on brain in increasing order
judgement and reasoning –> vision and speech –> coordination of voluntary muscles –> stupor/confusion –> respiration and heart action at 0.4% blood alcohol
Can brain cells regenerate?
vs liver cells
brain cells: no
liver: up to a point
Basic metabolism of alcohol
- happens where?
- 3 steps
- what is very reactive?
- accumulation of _________ = very detrimental on ?
- mostly in liver
1. alcohol to acetaldehyde by alcohol dehydrogenase
2. acetaldehyde to acetate by acetaldehyde dehydrogenase
3. acetate to acetyl-coA (with coA) - acetaldehyde –> convert ASAP to acetate
- acetyl-CoA –> energy metabolism
Which micronutrient is very important for NAD+?
Niacin
Alcohol dehydrogenase pathway
- ___% of ethanol goes through this pathway
- ADH synthesized by what? men vs women?
- ADH production inducible?
- what happens if not enough ADH?
- 70
- liver and men can produced it in stomach
- NOT inducible –> steady rates in liver
- if not enough ADH –> alcohol stays in blood system –> MEOS kicks in
Microsomal ethanol oxidizing system pathway:
- mechanism?
- ____% of ethanol
- enzymes from _______ delivered to _______ cells
- can also metabolize ______
- tolerance?
- inducible?
- alcohol to acetaldehyde using enzymes from mitochondria of liver + same rest pathway as ADH pathway
- 20%
- mitochondria –> liver cells
- drugs
- system involved in tolerance: can develop tolerance to what it’s metabolizing (drug or alcohol) –> becomes more efficient at metabolizing after repeated exposure
- yes!
how much % of alcohol goes directly in breath and urine?
10%
Lots of Acetyl-Coa and NADH will ?
- instead: converted to (2) + byproduct
- consequence?
bloc ability of acetyl-coa to go in TCA cycle
- so Acetyl-Coa converted into FA and protein + ketones
- consequence: fatty liver –> cirrhosis
Decreased gluconeogenesis because of alcohol leads to ?
ketosis
What leads to fatty liver?
Excess FA and ketones
excess alcohol = increase acetaldehyde –> 4 consequences
- decrease protein synthesis
- cell damage
- damages liver tissue = fibrosis –> scarring, liver tries to regenerate –> only leads to worse consequences
- leads to cirrhosis = irreversible
what promotes conversion of pyruvate to lactate acid (instead of acetyl-Coa)? (2)
consequence?
- no TCA cycle (blocked by excess acetyl-coA)
- excess NADH (less NAD+)
consequence: increases acidity in body! –> acidosis
Cirrhosis
- what is it?
- mechanism (4)
- reversible?
- leads to ?
- treatment?
- irreversible liver damage caused by alcohol, hepatitis B or C, iron toxicity (hemochromatosis)
- as liver constantly repairs, accumulation of fibrosis tissue –> scars, nodules and connective tissue –> impaired function
- irreversible
- carcinoma/cancer
- liver resection or transplant
Most severe complication associated with excess alcohol intake?
Cirrhosis
Alcohol = ________ calories
- 1g OH = ____ kcal?
empty. 7 kcal/g
Impacted liver tissue leads to compromised vitamin status (4)
- Kernicke-Korsakoff syndrome: B1 (thiamin) destruction/deficiency
- anemia –> promotes folate excretion
- decreased vit D activation in liver (to hormonal form: calcitriol)
- B6 loss from binding protein
What type of anemia does impacted liver tissue leads to?
Megaloblastic because lack of folate
What does aldosterone system do?
what causes negative impact on aldosterone system? (3 steps)
- maintains fluid status
- alcohol –> leads to more excretion of water = dehydration
What system maintains fluid status?
Aldosterone system
Will alcohol increase or decrease FA, protein and gluconeogenesis
- increase FA synthesis
- decrease protein synthesis (increase catabolism)
- decrease gluconeogenesis
Drinking alcohol during pregnancy threatens fetus with (4)
- name of syndrome?
- irreversible brain damage
- cognitive impairment
- growth restriction
- facial and vision abnormalities
- fetal alcohol syndrome
Direct and indirect damage of fetal alcohol syndrome
direct: intoxication –> teratogenic effects
indirect: malnutrition –> if heavy alcohol consumer, nutrition status compromised
french paradox:
- low prevalence of CVD despite high ________ intake
- hypothesis?
- high sat fat intake
- red wine consumption contains resveratrol –> protects against LDL oxidation
We know that alcohol has some links to increased ____ if consumed moderately
HDL
Even moderate alcohol consumption associated with (9)
- hypertension, stroke
- cirrhosis
- cancer
- ulcers
- osteoporosis
- psychological depression
- fetal alcohol syndrome
- insomnia
- alcoholism
how many drink metabolized by liver per hour? because of what?
1 drink/hour
- because of set number of alcohol dehydrogenase
alcohol consumption during pandemic –> ______ study
- extra 1 drink/day for a year = ________ added deaths
- extra 1 drink/day for 5 years = _________ added deaths per year
- modeling study
- 9000
- 11 000
in US
screening tool for possible alcohol issue:
CAGE
- Cut down. thoughts about cutting down drinking?
- Annoyed by criticism?
- Guilty about drinking?
- Eye-opener –> started day with alcohol cause too stressed?
Treatment for alcohol issue
- usually _______ of active treatment
- medication: antabus and reviva = primary therapy?
- A + AA
- 2
- antabus (blocks Acetaldehyde DH) –> hangover immediately
- Reviva (opioid receptors –> decreases craving and feeling of high)
- meds = not primary therapy –> too long = negative physiological impacts
- Abstinence + alcoholics anonymous
