Environmental Disorders 03: Drugs Flashcards
What are the levels of alcohol consumption that cause drowsiness?
200 mg/dL
What are the levels of alcohol consumption that cause stupor?
300 mg/dL
Why is gastric metabolism of alcohol decreased in women?
dec. levels of alcohol dehydrogenase
Understand the main points in this chart.
Understand.
What is the pathology behind Asian flush syndrome?
Substitution of lysine for glutamine at residue 487 (normal allele ALDH21, inactive variant ALDH 22)
ALDH22 protein has dominant-negative activity (one copy of ALDH22 allele ↓ acetaldehyde dehydrogenase activity)
C/F of Asian flush syndrome?
- Experience nausea, flushing, tachycardia, and hyperventilation
How does too much oxidation of alcohol lead to NAD deficiency and what are the effects?
Alcohol oxidation by alcohol dehydrogenase reduces NAD to NADH leading to an increase in the NADH/NAD ratio * NAD deficiency
- Accumulation of fat in the liver
- Lactic acidosis
Metabolism in the liver of alcohol by what enzyme produces reactive O2 species?
CYP2E1
Alcohol can cause release of endotoxin from gram-negative bacteria in intestinal flora. How can this then affect the liver?
- stimulates production of TNF and other cytokines from macrophages and Kupffer cells, leading to hepatic injury
How does alcohol affect the CNS?
Low levels acts as depressant
Higher levels act as stimulant
At even higher levels lower medullary centers of respiration are depressed.
How does chronic alcoholism change the gross appearance of the liver?
- Fatty change followed by alcoholic hepatitis and cirrhosis
There is an increased risk of what type of cancer when one has cirrhosis and why does this occur?
- Cirrhosis is associated with portal hypertension and ↑risk for hepatocellular carcinoma
What are ways chronic alcoholism can affect the GI tract?
massive bleeding from gastritis, gastric ulcer
Mallory-Weiss syndrome: tear of distal esophagus due to retching
Boerhaave Syndrome rupture of distal esophagus due to retching
Esophageal varices (associated with cirrhosis)
Peripheral neuropathies and Wernicke-Korsakoff syndrome is caused by what deficiency that is du to chronic alcoholism?
thiamine (Vit B1) deficiency
How is central pontoon myelonosis caused in an alcoholic?
due to rapid IV fluid correction of hyponatremia
How does chronic alcoholism affect the heart?
leads to Dilated congestive cardiomyopathy (Alcoholic Cardiomyopathy) Hypertension: ↑ catecholamines
Dec HDL > inc risk of CHD
How does chronic alcoholism affect the pancreas?
acute and chronic pancreatitis
How can chronic alcoholism affect the baby during pregnancy?
Fetal alcohol syndrome (microcephaly, growth retardation, and facial abnormalities in the newborn)
How can chronic alcohol consumption affect hamtopoiesis?
Folic acid deficiency: ↓reabsorption in jejunum; macrocytic anemia
Acquired sideroblastic anemia: defect in heme synthesis
Anemia of chronic disease: common anemia in alcoholics
How can chronic alcoholism affect the MSK?
rhabdomyolysis (direct alcohol effect on muscle)
Drinckers with 1 copy of ALDH2*2 allele are at inc. risk for what type of cancer?
esophageal cancer
Lab findings for chronic alcoholism.
inc risk for developing an inc. anion gap metabolic acidosis
lactic acidosis
B-OHB ketoacidosis
Hyperuricemia because lactic acid competes with uric acid excretion
Hypertriglyceridemia because inc. Production of glycerol 3-phosphate, the key substrate for triglyceride synthesis in the which is the key substrate for triglyceride synthesis in the liver.
AST> ALT because alcohol is a mitochondrial toxin that causes release of AST
Inc serum GGT alcohol induces SER hyperplasia causing inc synthesis of GGT
What is methanol used as typically?
windshield washer fluid (end product: formic acid)
What is methanol the main complication of ingestion of methanol?
blindness due to optic atrophy
