Alcohols

Question 1

what are the 2 ways which ethanol can be metabolized?

Answer 1

1. Alcohol dehydrogenase
   - requires NAD+ (made by the pyruvate to lactate)
2. MEOS (Microsomal ethanol-oxidizing system)
   - which is activated at 0.1g/dL
   - broken down by CYRP2E1
   - needs NADPH to work

Question 2

What is also broken down by CYRP2E1?

Answer 2

acetaminophen

Question 3

Metabolism of ethanol ?

Answer 3

Ethanol– Acetaldehyde– acetate

- zero-order kinetics and thus concentration independent

Question 4

What breaks down ETOH to acetaldehyde?

Answer 4

Alcohol dehydrogenase (found in liver and gut)
MEOS

Question 5

What breaks down acetaldehyde into acetate?

Answer 5

Aldehyde dehydrogenase which happens in kidneys

Question 6

What are the Symptoms of accumulation of acetaldehyde?

Answer 6

Facial flushing
N, V
Dizziness
HA

Question 7

What inhibits aldehyde dehydrogenase?

Answer 7

1. Disulfiram (which leaves you will more acetaldehyde and more hangover and unwanted symptoms)
2. Metronidazole
3. 2nd generation Cephalosporins
   - which are affective against
   Gram-positive cocci
   Certain gram-negative bacilli

Question 8

Added CNS depression with the addition of what else?

Answer 8

Sedative- hypnotics like benzos
Opioid agonists
H1 antagonists (which are histamine blockers) given to act against allergic reactions

Question 9

what are some of the effects of ethanol?

Answer 9

Vasodilation

• depression of vasomotor center in CNS
• direct SM relation due to acetaldehyde
• hypothermia since our body thinks we are warm

Uterine relaxation

Depression of myocardial contractility

Question 10

What is the purpose molecular mechanism of ethanol?

Answer 10

• Facilitates the action of GABAa receptors
• Inhibits the ability of glutamate to activate NMDAr
• — could be the likelihood of blackouts since we don’t have glut to and decreased cAMP, ions, and phospholipase C which are all needed to make memories

Question 11

What are the DT’s?

Answer 11

Delirium tremors 
- delirium
- agitation
- autonomic ns instability
- low grade fever and diaphoresis 
can result in death and caused by ethanol withdrawal

Question 12

What is the most common CNS abnormality with chronic ethanol use?

Answer 12

Peripheral neuropathy

Question 13

What is Wernicke- Korsakoff’s syndrome?

Answer 13

Alcohol abuse + thiamine deficiency

• rare but causes ataxia, confusion, and paralysis of EOM
• can progress to coma or death
• thiamine can fix symptoms

Question 14

What are some of the clinical effects based off of blood alcohol content?

Answer 14

50-100= sedation, high, and slower reaction time
100-200= impaired motor function, slurred speech, ataxia
200-300= emesis and stupor
3000-400- coma
>400 respiratory depression and death

Question 15

What is permanent memory disorder caused by alcohol abuse and thiamine deficiency?

Answer 15

Korsakoff’s psychosis

Question 16

Chronic ethanol use and cv effects?

Answer 16

HTN, Anemia, and dilated cardiomyopathy
bindge drinking can cause arrhythmias
1-2 drinks a day can raise HDL’s

Question 17

what are some of the effects of chronic ETOH on the GI system?

Answer 17

irritation, inflammation, bleeding, scarring of gut wall
absorption defects and thus nutrient deficiencies
increases risk of pancreatitis

Question 18

Causes of chronic ETOH on liver?

Answer 18

Most common medical condition
- fatty liver– hepatitis- cirrhosis- liver failure
worse and women and exacerbated by hepatitis B and C

Question 19

What are 2 other alcohols that are broken down by alcohol dehydrogenase?

Answer 19

Methanol- Severe acidosis and retinal damage

Ethylene glycol- acidosis and nephrotoxic

Question 20

what is Fomepizole?

Answer 20

It is a drug that inhibits alcohol dehydrogenase, which doesn’t let methanol be converted to formaldehyde or formic acid and ethylene glycol be converted to toxic aldehydes and oxalic acid.

Question 21

What are some symptoms of Ethylene glycol toxicity or AE?

Answer 21

V, depression, ataxia, weakness, flaccid para, convulsion, coma and death
as well as renal failure, emesis, dehydration, weight loss, hematuria, anuria

Question 22

What are some of the symptoms of methanol toxicity and AE?

Answer 22

Blurred vision, coma death and blindness if they survive.

Question 23

ETOH CNS depressant means?

Answer 23

Disinhibition of euphoria
relaxant
anesthetic and analgesic