S59 - Drug and alcohol Flashcards
80% of alcohol is metabolized by alcohol dehydrogenase to form acetyl aldehyde which is further metabolized by alaldehyde dehydrogenase
True
Forms Acetyl CoA and Acetate
Acetate –> citric acid cycle –> CO2 / water
Alcohol has shown to be associated with > 60 different medical conditions.
true
Typical drink has 12 gms of EtOH.
true
Liver cancer 2-1
Oralpharageal 2-1
Stroke 18-1
Motor vehicle 3-1
Incidence men higher than women
true
Consumption of > 70 gm/day has a higher risk of CHD than the other 2 groups. Accelerates quickly.
true
Compared to non-drinkers, low-to-moderate drinkers (< 20 gm/day) have a lower risk of CHD. Cardioprotective effect (1 glass red wine…).
true
Differences between “developing” countries and “developed” countries.
Cancer and CHD incidences are lower in developing countries (they have other problems).
12 gm EtOH average drink (12 oz beer; 4 oz wine; 1.5 oz shot 80 proof).
true
Alcohol-Related Medical Conditions
Pancreas and Liver: acute pancreatitis 3-fold increase; liver problems are common with chronic use (more later).
Cancer: 1.5 drinks/day increase a woman’s risk by 1.4 fold.
Esophageal increase 3-fold, rectal increase 1.5-fold.
7-8 drinks/day => increase 5-fold for many other types
Alcoholic-Liver Disease (ALD). Three major conditions –
fatty liver disease;
alcoholic hepatitis;
cirrhosis.
Fatty liver present > 90%, smaller amount progress to alcoholic hepatitis (10-20%) and then => cirrhosis (15%).
true
Alcohol-Related Medical Conditions
Vitamins A, C, E, and selenium are depleted.
true
Alcohol-Related Medical Conditions Vitamin B1 (thiamine): Wernicke’s encephalopathy. Routine use for all patients. B3 and B6 (-) also contributes.
true
Alcohol-Related Medical Conditions
Vitamin B12: megaloblastic anemia and folate (-).
Folate (-) => Vitamin K decrease => bleeding increase.
true
Alcohol-Related Medical Conditions
Vitamin D: decrease bone density and mass.
true
Tobacco and smoke contains 6,700 compounds, 63 are known carcinogens and 11 are definite human carcinogens.
true
Three main areas of medical conditions associated with tobacco – CHD, cancer and pulmonary.
true
Tobacco-Related Medical Conditions
CHD – Odds Ratio (OR): 1.27 (p < 0.001).*
Pulmonary: COPD OR 1.45 (p < 0.008).*
Cancers:*
Oropharynx: OR 2.61 (p < 0.02).
Upper respiratory tract: OR 2.02 (p < 0.04).
Lung: OR 2.14 (p < 0.02).
All cancer types together: OR 1.42 (p < 0.04)
Waterpipe smoking is just as “bad” as cigarettes/cigars.
E-cigarettes: Data coming in – it is alarming!
true
Does it really help people to stop smoking?
E-cigs, CDC Reports – most commonly used tobacco product among youth (12-17 yrs).
true
E-cigarettes: > 2 million (2016) middle and high school used < 30 days
true
E-cigarettes:
Adults 18-24 yrs: 40% had never used cigarettes
Adults > 40 yrs: only 1.3% never used
Adults 3.2% (2016) used
Adults: 58% regular cigarettes users; 30% former users; and 11.4% never used
true
Pregnancy*: women still smoke……..
US about 12%; other world areas as high as 30%…..
Problems – ectopic pregnancy, placenta previa and abruption, stillbirth, and premature membrane rupture.
true
Decreased birth weights.
US: 20-30% low birth weight from smoking.
Risk of preterm birth doubles.
Economic costs – NICU’s, medical problems….
Possible long-term medical problems
true
