Alcohols Flashcards
what are the 2 ways which ethanol can be metabolized?
- Alcohol dehydrogenase
- requires NAD+ (made by the pyruvate to lactate) - MEOS (Microsomal ethanol-oxidizing system)
- which is activated at 0.1g/dL
- broken down by CYRP2E1
- needs NADPH to work
What is also broken down by CYRP2E1?
acetaminophen
Metabolism of ethanol ?
Ethanol– Acetaldehyde– acetate
- zero-order kinetics and thus concentration independent
What breaks down ETOH to acetaldehyde?
Alcohol dehydrogenase (found in liver and gut) MEOS
What breaks down acetaldehyde into acetate?
Aldehyde dehydrogenase which happens in kidneys
What are the Symptoms of accumulation of acetaldehyde?
Facial flushing
N, V
Dizziness
HA
What inhibits aldehyde dehydrogenase?
- Disulfiram (which leaves you will more acetaldehyde and more hangover and unwanted symptoms)
- Metronidazole
- 2nd generation Cephalosporins
- which are affective against
Gram-positive cocci
Certain gram-negative bacilli
Added CNS depression with the addition of what else?
Sedative- hypnotics like benzos
Opioid agonists
H1 antagonists (which are histamine blockers) given to act against allergic reactions
what are some of the effects of ethanol?
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
What is the purpose molecular mechanism of ethanol?
- 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
What are the DT’s?
Delirium tremors - delirium - agitation - autonomic ns instability - low grade fever and diaphoresis can result in death and caused by ethanol withdrawal
What is the most common CNS abnormality with chronic ethanol use?
Peripheral neuropathy
What is Wernicke- Korsakoff’s syndrome?
Alcohol abuse + thiamine deficiency
- rare but causes ataxia, confusion, and paralysis of EOM
- can progress to coma or death
- thiamine can fix symptoms
What are some of the clinical effects based off of blood alcohol content?
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
What is permanent memory disorder caused by alcohol abuse and thiamine deficiency?
Korsakoff’s psychosis
Chronic ethanol use and cv effects?
HTN, Anemia, and dilated cardiomyopathy
bindge drinking can cause arrhythmias
1-2 drinks a day can raise HDL’s
what are some of the effects of chronic ETOH on the GI system?
irritation, inflammation, bleeding, scarring of gut wall
absorption defects and thus nutrient deficiencies
increases risk of pancreatitis
Causes of chronic ETOH on liver?
Most common medical condition
- fatty liver– hepatitis- cirrhosis- liver failure
worse and women and exacerbated by hepatitis B and C
What are 2 other alcohols that are broken down by alcohol dehydrogenase?
Methanol- Severe acidosis and retinal damage
Ethylene glycol- acidosis and nephrotoxic
what is Fomepizole?
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.
What are some symptoms of Ethylene glycol toxicity or AE?
V, depression, ataxia, weakness, flaccid para, convulsion, coma and death
as well as renal failure, emesis, dehydration, weight loss, hematuria, anuria
What are some of the symptoms of methanol toxicity and AE?
Blurred vision, coma death and blindness if they survive.
ETOH CNS depressant means?
Disinhibition of euphoria
relaxant
anesthetic and analgesic
