Alcohol symposium Flashcards
top 5 causes of admission to hospital due to alcohol
unintentional injuries eg falls mental ill health heart conditions and stroke liver and pancreatitis cancer
What organ processes alcohol?
liver
Main functions of the liver
CHO metabolism = glycogenesis and glycogenolysis
fat metabolism = lipid metabolism, fats –> phospholipids and cholesterol
protein metabolism - deamination, albumin, ammonia
storage - glucose, iron, copper, vitamins
synthesis - fibrinogen, thrombopoetin
Kupffer cells
produce bile
metabolism of drugs and alcohol
Alcohol - what breakdown product is carcinogenic?
acetylaldehyde
Enzymes involved in alcohol breakdown
ADH and ALDH
How many units of alcohol per week keep health risks low?
<14
Acetylaldehyde broken down into?
acetate
Other important factors with alcohol consumption and health risks
nutrition genetic differences other drugs co-existing virus eg Hep C dependence and progression female
Causes of cirrhosis
alcohol, fatty liver, Hep C, autoimmune
Progression of alcohol related liver disease
normal - steatosis - steatohepatitis - fibrosis - cirrhosis
What stage of alcohol related liver disease is reversible?
steatosis
How steatosis arises
alcohol - acetylaldehyde - acetate - fatty acids
calorie rich
fat deposited around central vein then parenchyma
6 indicators of chronic alcohol use
history macrocytosis increased ferritin low platelets elevated gamma GT enlarged liver on AUSS
Alcoholic hepatitis
fatty change and infiltration with leucocytes, hepatic necrosis
Signs/symptoms of alcohol hepatitis
abdominal pain, jaundice, fever, hepatomegaly, decompensation
Score used to determine 28 day survival rate with alcoholic hepatitis and what it includes
Glasgow alcoholic hepatitis score
age, markers of inflammation and liver function
Management of alcoholic hepatitis
abstinence, steroids, treat infection, nutrition
Liver fibrosis
chronic inflammation
activation of stellate cells
collagen production and scarring
How to identify liver fibrosis
fibroscan
Complications of cirrhosis
variceal haemorrhage
encephalopathy
ascites
hepatocellular carcinoma
In low doses, alcohol…
euphoria, decrease anxiety, sociability
In high doses, alcohol…
intoxication, impaired attention, nystagmus, slurring, disinhibition, mood instability
Intoxication
The pathological state produced by a drug, serum, alcohol or any other toxic substance
Diagnosing alcohol dependency
acute intoxication
harmful use
dependence
withdrawal state
dependence symptoms
cravings, difficult controlling use, primacy, increased tolerance, persistence, physiological withdrawal
Withdrawal symptoms
tremor, weakness, nausea, vomit, anxiety, seizures, confusion, agitation, death
DELIRIUM TREMENS
How alcohol effects life negatively
physical, mental, relationships, work
Wernicke’s encephalopathy
confusion, ataxia, opthalmoplegia, nystagmus
What causes Wernicke’s encephalopathy and Korsakoff’s psychosis?
thiamine deficiency
Screening tools
CAGE - 2 or more
FAST, AUDIT, PAT
Managing alcohol dependency
practical advice, holistic approach, CBT/AA, medication, social work
Medication for alcohol dependency
chlordiazepoxide
thiamine
Licensing act
2005
7 messages of the industry
non-drinkers do not exist
alcohol is normal, common, healthy and responsible
ignore harmful and addictive
damage by small group of deviants
only solved when all parties work together
helping consumer choose
education about responsible use is best prevention
