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Lecture week 4 > Alcohol and health > Flashcards

Alcohol and health Flashcards

1
Q

Examples of one unit are

A

1 unit:

  • half pint of a regular beer, lager or cider
  • a small glass of wine
  • a small glass of sherry
  • a single measure of spirits
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2
Q

how to work out units based on % of alcohol?

A

% of unit in one litre = number of units in one litre

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3
Q

Is Alcohol withdrawal life threatening?

A

Yes - it leads to cardiac arrhythmias

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4
Q

Do the patient always need to completely stop drinking?

A

It would be good, but any reduction (e.g. 10% reduction in alco intake) will bring significant benefits

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5
Q

Bad effects of long term alcohol consumption

A

It is related to ‘large amount consumption’

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6
Q

Psychological aspects of alco consumption

A
  • cravings
  • irritability
  • anti-sociality
  • depression
  • anxiety
  • panic
  • psychosis
  • hallucinations
  • delusions
  • sleep disorder
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7
Q

How alcohol can affect sleep?

A

It lowers quality of sleep

*does not help with sleep

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8
Q

Pathway of alcohol-related liver disease

A

steatosis (fat accumulation in the liver) -> inflammation -> collagen deposition -> fibrosis -> cirrhosis -> hepatocellular carcinoma

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9
Q

What is typical characteristic feature of cirrhosis

A

Nodule formation

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10
Q

Acute alcoholic hepatitis

Clinical presentaiton

A

Acute alcoholic hepatitis

  • rapid progression of jaundice
  • fever
  • abdominal pain
  • leucocytosis
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11
Q

Histology of acute alcoholic hepatitis

A
  • neutrophil infiltration
  • marked fatty change
  • Mallory’s hyaline
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12
Q

Consequences of liver cirrhosis

A
  • portal hypertension
  • poor liver function
  • liver cancer
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13
Q

What (in re to alcohol disease) causes ascites?

A

Ascites may be a consequence of an increased portal hypertension and low albumin

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14
Q

Treatment of ascites

A

Ascites - transudate

  • fluid restriction
  • salt restriction
  • diuretics
  • paracentesis
  • TIPS
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15
Q

What’s transudate ?

A

Fluid produced by an organ that has failed (e.g. HF, ascites)

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16
Q

TIPS

What’s that? (simply)

A

Stent put to bypass between hepatic vein and portal vein

17
Q

Can the liver repair itself and regenerate?

A

It can, but only up to the point of cirrhosis

*cirrhosis is fixed - cannot get back from that

18
Q

What’s the recommendation for pregnant women in terms of pregnancy?

A

No alcohol - the safest thing to do

19
Q

Clinical presentation of Foetal Alcohol Syndrome

A

FAS

  • mental retardation
  • epicanthal folds
  • flat nasal bridge
  • deformed ears
  • upturned nose
  • smooth philtrum
  • thin upper lip
20
Q

What happens to alcohol consumed during pregnancy lead to FAS?

A
  1. Alcohol crosses the placenta -> entered into foetal circulation
  2. Alcohol metabolism in foetal tissues: alcohol + fatty acids -> fatty acids ethyl esters

*fatty acids ethyl esters can be detectable in meconium

21
Q

What’s the name of the drug that is commonly used to Rx alcohol dependence?

A

Acamprosate

*used alongside with counselling

22
Q

What’s the MoA of Acamprosate?

A

Acamprosate

* used to Rx alcohol dependence

MoA:

  1. NMDA receptor antagonist

Chronic alcohol consumption -> overproduction of NMDA

Stopping alcohol -> sudden additional upregulation of NMDA -> symptoms: delirium tremens and excitotoxic neuronal death

So antagonist of NMDA will help with these

  1. positive regulation of GABA-A

In chronic alco consumption, GABA is down-regulated; down- regulated GABA = less GABA = less opposition of neuronal excitation = withdrawal symptoms (if no alcohol)

23
Q

Disulfiram - MoA and use in alcohol cessation

A

Disulfiram

Use: relapse prevention

MoA: blocks aldehyde dehydrogenase in the liver -> increased acetaldehyde -> effects of hungover and feeling as if ‘a person is gonna die’*

*therefore a person would be likely to avoid the alcohol intake

24
Q

Role of benzodiazepines in alcohol cessation

A

MoA: Increase GABA -> fewer side effects of withdrawal

Use: medically assisted withdrawal

25
Q

How much of regular alcohol intake is safe?

A
  • No more than 14 units per week
  • if a person drinks 14 units per week - better to spread it evenly over 3 days or more (rather than binge)

Lecture week 4 (18 decks)

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