Alcohol Misuse Flashcards
1
Q
Where does alcohol metabolism take place?
A
- the liver
- 90%
- alcohol distributed throughout body water
- very little enters body fat
2
Q
How does alcohol absorption occur?
A
- alcohol is water soluble
- slowly absorbed from stomach
- more rapidly absorbed in small intestines
- aerated alcohol gets into the system more quickly
- rate of absorption quicker on an empty stomach
- spirits delay gastric emptying and are absorbed slower
- food retards absorption
3
Q
How is alcohol metabolised?
A
alcohol -> acetaldehyde -> acetate -> CO2 and water
4
Q
What impacts on blood alcohol concentration?
A
- age
- sex
- sixe
- body build
- previous exposure
- type of drink
- food eaten
- cimetidine
- delayed gastric emptying
- reduced absorption
- antihistamines
- faster gastric emptying
- increased absorption
5
Q
How does blood alcohol concentration vary when consuming alcohol?
A
- peaks 1 hour after drinking on an empty stomach
- declines over next 4 hours
- removed at rate of 15mg/100ml/hr
- detectable levels still present for several hours
6
Q
What contributes to alcohol tolerance?
A
- microsomal ethanol oxidising system
7
Q
What is intoxication?
A
- mild sedative
- mild anaesthetic
- stimulation of dopamine and serotonin
- sense of well-being, relaxation and disinhibition
- elation and aggression
- 100mg/100ml
- slurred speech and unsteadiness
- 200mg/100ml
- fatal
- > 400mg/100ml
- atrial fibrillation, respiratory failure, inhalation of vomit
8
Q
What is the safe weekly alcohol limit?
A
- 14 units
- spread over >3 days if regular
9
Q
What medical problems are associated with chronic heavy drinking?
A
- GI tract
- acute gastritis
- liver problems
- GI bleeding
- cancer
- pancreatic disease
- obesity and malnutrition
- vitamin deficiencies (B1, B2, B6, E, D)
- heart
- cardiomyopathy
- arrhythmias
- hypertension
- increased triglycerides and LDL cholesterol
- traumatic injuries
- skin, muscles, nerves and bones
- acute or chronic myopathy
- osteoporosis
- osteomalacia
- blood
- macrocytosis
- thrombocytopenia
- leucopoenia
- poor wound healing
- drug implications
- impaired drug metabolism
- drug interactions
- non-compliance
- interactions with illicit drugs
- gynaecological and obstetric problems
- immune system
- mental health
- nervous system
- epilepsy
- cerebral atrophy
- chest
- renal
10
Q
What oral problems are associated with chronic heavy drinking?
A
- oral ulceration
- nutritional deficiency
- glossitis
- nutritional deficiency
- angular chelitis
- nutritional deficiency
- gingivitis
- nutritional deficiency
- dental neglect
- dental trauma
- chaotic lifestyle
- lost dentures
- cancer
- increased with concurrent tobacco use
- salivary gland enlargement
- sialrsis
- xerostomia
- poor wound healing
- osteomyelitis
- supression of immune system
- dental erosion
- bruxism
11
Q
What is alcoholic liver disease?
A
- liver damage
- alcohol and metabolites
- progression:
- normal
- steatosis (fatty liver)
- steatohepatitis
- cirrhosis
- unusal
- most heavy drinkers don’t develop alcohol-related injury
12
Q
What is cirrhosis?
A
- irreversible scarring and presence of nodules on the liver
- alcohol most common cause
- 20% heavy drinkers
- morbidity common
- bleeding
- jaundice
- ascites
- cachexia
- infections
- encephalopathy
13
Q
What problems does liver disease present in dentistry?
A
- reduced synthesis of clotting factors
- reduced absorption of vitamin K (II, VII, IX, X)
- thrompocytopenia associated with portal hypertension
- reduced platelets due to reduced megakaryocytic maturation
- reduced platelet aggregation
- overall result is prolonged bleeding
- reduced drug metabolism
- LA
- analgesia
- sedatives
- anti-biotics
14
Q
How does alcohol interact with illegal drugs?
A
- cocaine
- prolonged effect
- cannabis
- reduced absorption of alcohol
- increased confusion and disorientation
- accidents more likely
- amphetamines
- increased impairment of judgement
- ecstasy
- increased intoxication
- potentially fatal fluid retention
15
Q
What is cariomyopathy?
A
- degenerative heart disease
- no coronary artery disease
- often asymptomatic
- can lead to arrhythmias, cardiomegaly and congestive heart failure
