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Toxicology 2 Flashcards

1
Q

Review or memorize the 5 potential therapeutic uses of alcohol?

A
  1. externally as a rub
  2. injection into nerve plexi
  3. improve appetite in elderly and to provide calories
  4. for extraction and application of medical compounds from plants
  5. beneficial side effects on CV stem and maybe on cancer
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2
Q

Why do some alcohols need to be distilled?

A

fermentation ends due to yeast dying in higher amounts of alcohol. Distillation increases alcohol content

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3
Q

Is absorption of alcohol from the GI tract fast or slow? what is the effect of food on this?

A
  1. stomach and small intestine absorb pretty rapidly

2. food decreases rate of absorpton

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4
Q

What are the characteristics of distribution of alcohol in the body?

A

Fast distribution, volume is correlated to total body water.
Concentration in a tissue is proportional to water in the tissue

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5
Q

After absorption, where does all the alcohol go?

A

liver

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6
Q

What is the blood alcohol concentration?

A

expressed as grams of ETOH per 100ml blood,

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7
Q

How much do you limit 1/2 drink from your body?

A

1/2/ drink/ hour

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8
Q

How much drinks results in .03 increase in BAC?

A

1 drink

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9
Q

Where is the main place for alcohol secretion and metabolism?

A

liver

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10
Q

the first step of ethanol metabolism is caused by what enzyme? what type of kinetics? rate? what does ethanol become?

A
  1. alcohol dehydrogenase
  2. 0 order kinetics
  3. 6-8 grams /hr
  4. acetaldehyde
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11
Q

Is cytochome P450 used in alcohol metabolism?

A

yes but smaller amount

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12
Q

what enzyme catalyzes the second step of alcohol metabolism? fast or slow?

A
  1. acetaldehyde dehydrogenase

2. fast

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13
Q

Is acetaldehyde harmful to the body?

A

yes

  • cross linking
  • carcinogenic imino derivatives
  • thial intermediate
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14
Q

does alcohol facilitate GABA activation?

A

inhibition- primary depressant effects

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15
Q

Does alcohol have direct effects on respiratory system?

A

No- until high levels, but it is indirect through the brainstem

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16
Q

What is the primary cause of acute alcohol lethality?

A

respiratory depression

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17
Q

What does alcohol do to the CV system>??

A
  1. vasodilation- hypothermia deaths

2. increases HDL and decrease LDL

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18
Q

does alacohol inhibit the anti-diuretic hormone?

A

yes

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19
Q

can a high dose of alcohol stimulate appetite and a low dose depress appetite?

A

other way around

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20
Q

Liver toxicity due to changed lipid metabolism and nadh accumulation leads to what 3 main disease?

A

fatty liver, toxic hepatitis, cirrhosis

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21
Q

What is prominent feature of acute alcohol poisoning?

A

CNS symptoms

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22
Q

Acute alcohol poisoning affects gluconeogenesis and might cause what?

A

hypoglycemia

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23
Q

some malnourished patients with alcohol toxicity develop what?

A

alcoholic ketoacidosis

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24
Q

With chronic alcohol abuse, what happens to appetite?

A

lose it

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25
Q

With chronic alcohol abuse, what happens to vitamin and nutrients?

A

become deficient

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26
Q

With chronic alcohol abuse, do we become ketotic?

A

Yes, wernicke korsakoff syndrome due to Vit B1/thiamine deficiency

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27
Q

With chronic alcohol abuse, what happens tour stomach?

A

ailments, ulcers, diarrhea

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28
Q

With chronic alcohol abuse, what happens to our skin?

A

increased problems

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29
Q

With chronic alcohol abuse, what happens to sexual potency?

A

impotence, testicular atrophy, gynecomastia and testosterone drop

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30
Q

With chronic alcohol abuse, what happens tour heart?

A

cardiomyopathy

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31
Q

With chronic alcohol abuse, what happens to coagulation?

A

defect– decreased coagulation proteins

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32
Q

With chronic alcohol abuse, what happens to our CNS?

A

memory loss, dementia, cerebellar atrophy,

33
Q

With chronic alcohol abuse, what happens to our nerves?

A

peripheral neuropathy

34
Q

With chronic alcohol abuse, what happens tour AST and GGTP, triglycerides?

A

They go up

35
Q

With chronic alcohol abuse, what happens to glucose tolerance?

A

impaired glucose tolerance and diabetes mellitus (pancreatic injury)

36
Q

With chronic alcohol abuse, what happens to plasma magnesium and phosphate?

37
Q

With chronic alcohol abuse, what happens to plasma uric acid?

A

increased–> gout

38
Q

With chronic alcohol abuse, what happens to plasma folate?

A

goes down, megaloblastic anemia

39
Q

What are the 2 types of tolerances to chronic alcohol consumption?

A

metabolic and neuronal

40
Q

Is fatty liver reversible?

A

yes from a good diet and strict abstinence

41
Q

What are the major complications of liver cirrhosis?

A
  1. portal hypertension (varicose and hemorrhoids)
  2. salt and water retention (ascites, edema
  3. Cancer
42
Q

What are the major problems of liver transplantation in alcohol abusers?

A
  1. narcosis/drug
  2. other organ problems
  3. malnourished
  4. new liver endangered if not abstinence
43
Q

What are the 3 multifactorial risks to fatty liver?

A

genes, environment, alcohol

44
Q

What tells us we are alcoholic hepatitis?

A

only medium high AST levels for months

45
Q

What happens to NAD and OAA in alcoholism?

A

concentration is decreased by EtOH oxidation–this might lead to the decreased F.A. oxidation and increased fatty liver

46
Q

Acute intoxication reduces metabolizing activity?

A

Yes, reversible

47
Q

does Long term alcohol use increase or decrease microsomal enzyme activity? which enzymes? What about when it finally reaches cirrhosis?

A
  1. increase
  2. CYP2E, CYP3A
  3. overall metabolism reduced
48
Q

aspirin and Etoh leads to what?

A

gastric bleeding

49
Q

Are effects of CNS depressants and vasodilators and anti-coagulants exaggerated with alcohol?

50
Q

is there increased gastric uptake of penicillin with EtOh?

A

No reduced

51
Q

What are 5 things FAS children have?

A 
Mental retardation
smaller heads and brains
abnormal facial features
poor coordination
hyperactivity
52
Q

Alcoholism is a disease that includes what 4 symptoms?

A

craving
loss of control
physical dependence
tolerance

53
Q

How many alcohol abusers are in the US? how much of the annual health expenditure? how many deaths?

A

> 14million
8.1%
100,000

54
Q

What 3 races had the most alcoholics of persons greater than 11?

A

american indian> native hawaiian or islander>hispanic

55
Q

What age group has the highest alcohol abusers?

A

18-25> 26-34> 35-49

56
Q

When do seizures during alcohol withdrawal occur?

A

days 1-3 with minor symptoms

57
Q

What are minor symptoms of alcohol withdrawal?

A

tremor
insomnia
irritability

58
Q

What are the major symptoms of alcohol withdrawal?

A 
anxiety
agitation
diaphoresis
delirium
disorientation
59
Q

What is disulfiram?

A

aldehyde dehydrogenase inhibitor used to support alcoholism

60
Q

What are pyrazoles?

A

alcohol dehydrogenase inhibitor used to support alcoholism

61
Q

What is naltrexone used for in alcoholism?

A

opioid receptor antagonist–> inhibits desire for alcohol.

62
Q

Should we use anti-depressants to treat alcoholism?

63
Q

What is a dangerous alcohol with therapeutic use, flammable, hydroxyl derivative, miscible with water CNS depressant?

A

isopropanol

64
Q

What is a dangerous alcohol without therapeutic use, flammable, hydroxyl derivative, miscible with water CNS depressant?

A

methanol

ethylene glycol

65
Q

What is the 2nd most freq ingested alcohol?

A

isopropanol

66
Q

What are the kinetics of isopropanol?

A

rapid, metabolism to acetone, slow elimination in kidneys and lung (acetone breath)

67
Q

How potent is isopropanol a CNS depressant as EtOH?

A

twice- >3 swallows by a child contact health care

68
Q

Should we use EtOH as an antidote for isopropanol?

69
Q

Where can we find methanol?

A

antifreeze, paint remover

70
Q

Can methanol be absorbed through skin and lung exposure?

71
Q

How is methanol metabolized?

A

hepatic–to formaldehyde and formic acid

72
Q

how much of methanol is needed to cause blindness?

A

10 ml of 40%

73
Q

What correlates best with lethality of methanol?

A

blood acidosis

74
Q

Is ethylene glycol bitter?

A

no it is sweet> sweet man’s alcohol

[from antifreeze and coolant]

75
Q

What is ethylene glycol metabolized to/

A

glycoaldehyde
glycolic acid
oxalic acid

76
Q

What does ethylene glycol do to kidneys?

A

leads to failure and crystals in renal tubules (where it is filtered and reabsorbed)

77
Q

What is a major problem of ethylene glycol in the body?

78
Q

Is alcohol dehydrogenase metabolism lower or higher for methanol and ethylene glycol?

A

Much lower

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