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BDS3 1 > Alcohol > Flashcards

Alcohol Flashcards

1
Q

what advice is given for safe alcohol consumption. (2)

A

Do not drink > 14 units per week regularly

If you regularly drink 14 units per week, spread evenly over 3 days

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2
Q

why is the concentration of alcohol greater in the liver? (1)

A

due to the portal vein draining the stomach directly into the liver

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3
Q

what percentage of alcohol is metabolised in the liver?

A

90% of alcohol is metabolised in the liver

2-5% is excreted in bodily fluids i.e. sweat, urine and breath

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4
Q

what commonly used drug increases alcohol absorption?

A

Antihistamines

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5
Q

why does alcohol have a quicker effect on women? (2)

A

lower levels of the enzyme alcohol dehydrogenase in the stomach - more alcohol is absorbed before it begins to be metabolised

Woman have smaller blood volume than men

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6
Q

how much alcohol is removed per hour?

A

15mg/100ml of blood per hour

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7
Q

what is a fatal dose of alcohol?

A

> 400mg/100ml

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8
Q

what are the dental problems associated with heavy drinking? (10)

A

Oral cancers - Risk increases if used alongside smoking

malnourished - this causes oral ulceration, glossitis, angular chellitis, gingivitis.

Neglect for personal care = why oral cancer patients present very late on
Trauma 
Lost dentures 
Salivary gland enlargement - sialosis 
Xerostomia 
Poor wound healing and osteomyelitis which are partly due to the suppression of the immune system. 
Erosion 
Bruxism
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9
Q

describe how liver damage increases bleeding? (5)

A

Reduced production of clotting factors
Reduced Megakaryocyte maturation = few platelets
Reduced Platelet aggregation (reduced number & function)
Reduced absorption of vitamin K (which is used to produce clotting factors) therefore this affects the production of clotting factors 2, 7, 9 and 10
Thrombocytopenia (less platelets) from splenomegaly associated with portal hypertension

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10
Q

describe how liver damage interferes with drug metabolism? (3)

A

Induces the liver enzymes which increases the metabolism of some drugs which in turn would reduce plasma concentration of the drug and weaken it’s effects.

The liver damage associated with heavy drinking also reduces drug (analgesics, sedatives, antibiotics) and LA metabolism

Alcohol paired with sedative drugs can also suppress the nervous system and prolong the effects of the drug

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11
Q

what problems can arise in patients who drink heavily? (3)

A

prolonged bleeding

interferes with drug metabolism

GI bleeding - can’t prescribe NSAIDS

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12
Q

describe what occurs when alcohol and warfarin interact?

A

low amounts of alcohol ( 3 units per day) consumed regularly enhances warfarin metabolism = more powerful

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13
Q

describe what occurs when alcohol and paracetamol interact?

A

alcohol converts it to an intermediate metabolite which is hepatotoxic (however this is still the analgesic of choice)

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14
Q

describe how disulfiram works in deterring patients from drinking. (4)

A

Inhibits alcohol dehydroganase which converts acetaldehyde to acetate

If the patient does costume drink this drug inhibits the conversion of acetaldehyde and it accumulates within the body and causes the patient to feel nauseous and start to vomit.

The consumption of large amounts of alcohol with these drugs can lead to arrhythmias and hypotensive collapse

Other drugs can also cause these effects i.e. metronidazole, cephalosporins and ketoconazole.

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15
Q

what is holiday heart syndrome?

A

those who don’t drink regularly have a period of time where they drink increased amounts = sudden death.

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16
Q

what are the effects of alcohol on the heart/CV system ? (5)

A

Woman can develop problems whilst consuming less alcohol for smaller lengths of time

Cardiomyopathy
Arrhythmias 
Hypertension 
Stroke 
Protective effect
17
Q

what are the benefits of drinking moderate amounts of alcohol? (3)

A

reduces the risk of coronary artery disease mostly in older men and post-menopausal women.

Reduces gallstone formation

Reduces macular degeneration

18
Q

what is alcohol’s role in oral cancer? (4)

A

Ethanol metabolite acetaldehyde promotes tobacco initiated tumours (synergic effect)

Alcoholics tends to have a nutritional deficiency which thins the mucosa

Damages DNA and alters oncogene production

Alcohol facilitates the absorption of carcinogenic substances across the oral mucosa

19
Q

define and describe the 3 types of drinking.

A

Hazardous Drinking:
Risks for problems are likely

Harmful drinking:
Problems associated with alcohol are usually present (social i.e. not making work in the morning etc and medical problems)

Dependant drinking:
Alcohol needed to fundtion

20
Q

what type of drinker requires specialist intervention?

A

dependant

21
Q

name examples of alcohol screening tools and when they are used. (3)

A

FAST - the most practical and relevant in the GDP setting - recommended

CAGE - can be used in GDP but not on young people

CRAFFT - can be used in GDP specifically on young people

22
Q

FAST screening; what score does the patient need to achieve before becoming FAST positive?

A

> or equal to 3

23
Q

what intervention should we give as the dentist?

A

The (SIGN) Guidelines state that We should identify those who are harmful and hazardous drinking and deliver a brief 10 minute intervention

24
Q

AUDIT screening; what score for a woman indicated that they are a hazardous drinker?

A

7 - 13

25
Q

AUDIT screening; what score for a man indicated that they are a hazardous drinker?

A

8-15

26
Q

AUDIT screening; what score for a woman indicated that they are a harmful drinker?

A

14 - 20

27
Q

AUDIT screening; what score for a man indicated that they are a harmful drinker?

A

16 -19

28
Q

list what questions are asked in a CAGE screening (4) and what score indicated the patient has a problem (1)?

A

If you answer ‘yes’ to > 2 of these questions = problem

Have you ever felt you have to cut down on drinking?
Do you get annoyed at criticism of your drinking?
Do you feel guilty about your drinking?
Do you ever take a dink in the morning to get you started/ eliminate the shakes? (detecting dependant drinkers)

29
Q

describe the teachable moment. (2)

A

when people may be more receptive to change i.e. after witnessing someone else be injured or after experiencing other negative consequences of drink.

They need to be able to relate to the adverse effect to drinking

30
Q

how do we assess readiness to change?

A

use the readiness to change ruler

31
Q

describe the stages in the cycle of change.

A

contemplative

preparation

action

maintenance

relapse

precontemplative

32
Q

describe what a brief motivation intervention should include. (5)

A

We use behaviour change counselling

We should be non-judgemental

Should last between 5 - 2 minutes

We should encourage people to recognise their conflicting feelings towards their actual and ideal behaviour

We should encourage people to recognise that the responsibility of change lies with them

BDS3 1 (75 decks)

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