Alcohol related pathology

Question 1

Alcohol is classed as a drug based on what overall effect on the nervous system?

Answer 1

Depression of the CNS

Question 2

Which enzyme is involved in the metabolism of alcohol (ethanol)?

Answer 2

Alcohol dehydrogenase

Question 3

Describe intoxication (drunkeness)

Answer 3

An acute condition associated with a blood alcohol concentation higher than the processing capacity of the body’s metabolism for breaking down and eliminating ethanol

Various effects:
* Metabolic changes - low bsl
* Hypotension
* increased HR
* Vasodialtion
* Respiratory issue
* GI tract issues
* Euphoria
* slow movements/speech
* poor coordination
* reduced pain awareness
* unconsciousness

Question 4

Outline how alcohol is metabolised in the body

Answer 4

1. Alcohol (ethanol) is first turned into acetaldehyde by an enzyme called alcohol dehydrogenase. Acetaldehyde is a carcinogen but short-lived.
2. Another enzyme called aldehyde dehydrogenase converts acetaldehyde into non toxic acetate.
3. Acetate can then be turned into carbon dioxide and water, which the body can get rid of.
4. There’s another pathway involving an enzyme called cytochrome P450 2E1 (CYP2E1), but this can create harmful substances called reactive oxygen species (ROS), which can damage tissues and cause oxidative stress.

Question 5

Explain Wernicke’s encephalopathy in relation to chronic alcohol consumption

Answer 5

Wernicke’s encephalopathy: This is the acute phase and happens because of a deficiency in thiamine (Vitamin B1) from gastritis, which is common in heavy drinkers.

Symptoms: include confusion, impaired muscle coordination, and abnormal eye movements.

Question 6

Explain Korsakoff synrdrome in relation to chronic alcohol consumption

Answer 6

Korsakoff’s psychosis: This is the chronic phase and often follows Wernicke’s encephalopathy if left untreated.

Symptoms: It involves severe memory problems, difficulty forming new memories, and confabulation (making up stories to fill memory gaps).

Question 7

Oultine characteristics of mild alcohol withdrawal

Answer 7

Withdrawal often involves the limbic system and the response of the ANS.

Symptoms are typically the opposite of intoxication.

• hangover
  *craving
  *headache
  *Nausea & vomiting
  *Tachycardia
• Hypertension
  *Tremor
  *Insomnia

Question 8

Outline characteristics of severe alcohol withdrawal

Answer 8

Delirium tremens – most severe form of alcohol withdrawal

• Complete confusion
• Physical agitation
• Visual and/or auditory and/or tactile hallucinations
• Diaphoresis
• Fever
  *Tachycardia & HTN
  *Dehydration
  *Hypoglycaemia
  *Electrolyte imbalance