Drugs and Diseases: Ethanol Metabolism

Question 1

variant ALDH2: who is it in, describe Km, how is it inherited, what does it cause?

Answer 1

• Asians mostly
• high Km
• autosomal dominant
• facial flushing b/c increased circulating acetaldehyde
• higher risk for esophageal cancer

Question 2

what are blood diagnostic markers for acute pancreatitis?

Answer 2

increased pancreatic lipase and pancreatic amylase

Question 3

what can chronic exposure to acetaldehyde lead to?

Answer 3

hepatic inflammation + fibrosis -> portal HTN, cirrhosis

Question 4

what is wet beriberi?

Answer 4

“high output” heart failure

-vitamin B1 deficiency + cardiovascular disease

Question 5

how do you test for B1 deficiency?

Answer 5

transketolase

Question 6

what is Wernicke-Korsakoff syndrome and what does it cause?

Answer 6

type of B1 deficiency

• nystagmus
• ataxia
• confusion
• confabulation

Question 7

what is disulfram?

Answer 7

drug that irreversibly inhibits ALDH by competing for NAD binding site on enzyme (to treat alcholics)

Question 8

potential problems w/ disulfram

Answer 8

• if continue to drink -> acetaldehyde + DDC -> chelates Cu -> impairs dopamine beta-hydroxylase (psychotic)
• nyquil and tylenol can also induce this rxn

Question 9

brain-delirium tremens: explain this.

Answer 9

Etoh + GABA receptors -> enhances activity

withdrawal of Etoh -> decreased inhibition by GABA -> increased activity of Glu, dopamine, norepi -> tremors, anxiety, hallucinations, confusions, nausea

Question 10

how do you treat brain-delirium tremens from alcoholism?

Answer 10

w/ benzodiazepines