Symposium: Alcohol Flashcards
what are the steps of alcohol metabolism and where do they occur
- ethanol to acetaldehyde in cytoplasm
- acetaldehyde to acetate in mitochondria
what are the enzymes involved in alcohol metabolism
- alcohol dehydrogenase converts ethanol to acetaldehyde
- also catalase and P4502 E1 are minor pathway of this
- aldehyde dehydrogenase converts acetaldehyde to acetate
what are common polymorphisms in alcohol dehydrogenase
- B2 ADH in Asians
- B1 ADH in Northern Europeans
effects of the enzymes’ conversion of NAD+ to NADH on the cell
- increases lactate : pyruvate
- increases beta-hydroxybutyrate : acetoacetate
- inhibits glycolysis
- inhibits citric acid cycle
- inhibits fatty acid oxidation
- inhibits gluconeogenesis
toxic and metabolic effects of alcohol
- lipid peroxidation
- free radicals attack cellular and mitochondrial DNA
what is fomepizole
- competitive inhibitor of alcohol dehydrogenase
- used to treat methanol and ethylene glycol poisoning
how much is a unit
- 10ml of pure ethanol
- 8g of pure ethanol
what is low risk of units per week
14 units per week in at least 3 doses
what is the legal limit of alcohol while driving
< 80 mg/dL
<2-3 unit in females
< 3-4 units in males
what is increased risk of units per week
women: 14-35
men: 14 - 50
what are liver function tests for alcohol toxicity
- elevated GGT
- elevated transaminases
- increased globulin during cirrhosis
- increased INR and bilirubin
- decreased albumin due to liver failure
what are blood tests for alcohol toxicity
- macrocytosis
- increased ferritin
- hyperuricaemia
- hypertriglyceridaemia
- increased carbohydrate deficient transferrin
what are the zones of the liver
- zone 1: periportal
- zone 2: transitional
- zone 3: centrilobular
which zone of the liver is most susceptible to disease and why
zone 3
- has most metabolic activity
- least oxygen availability
characteristics of alcoholic liver disease
- steatosis
- steatohepatitis
- fibrosis / cirrhosis
- Mallory Denk bodies
