Toxicology II Flashcards

1
Q

Review or memorize the 5 potential therapeutic uses of alcohol?

A
  1. externally as a rub2. injection into nerve plexi3. improve appetite in elderly and to provide calories4. for extraction and application of medical compounds from plants5. beneficial side effects on CV stem and maybe on cancer
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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 rapidly2. food decreases rate of absorpton
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

After absorption, where does all the alcohol go?

A

liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the blood alcohol concentration?

A

expressed as grams of ETOH per 100ml blood,

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

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

A

1/2/ drink/ hour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How much drinks results in .03 increase in BAC?

A

1 drink

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Where is the main place for alcohol secretion and metabolism?

A

liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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 dehydrogenase2. 0 order kinetics3. 6-8 grams /hr4. acetaldehyde
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Is cytochome P450 used in alcohol metabolism?

A

yes but smaller amount

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

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

A
  1. acetaldehyde dehydrogenase2. fast
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Is acetaldehyde harmful to the body?

A

yes- cross linking-carcinogenic imino derivatives-thial intermediate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

does alcohol facilitate GABA activation?

A

inhibition- primary depressant effects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Does alcohol have direct effects on respiratory system?

A

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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the primary cause of acute alcohol lethality?

A

respiratory depression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What does alcohol do to the CV system>??

A
  1. vasodilation- hypothermia deaths2. increases HDL and decrease LDL
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

does alacohol inhibit the anti-diuretic hormone?

A

yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

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

A

other way around

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

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

A

fatty liver, toxic hepatitis, cirrhosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is prominent feature of acute alcohol poisoning?

A

CNS symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Acute alcohol poisoning affects gluconeogenesis and might cause what?

A

hypoglycemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

some malnourished patients with alcohol toxicity develop what?

A

alcoholic ketoacidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

With chronic alcohol abuse, what happens to appetite?

A

lose it

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

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

A

become deficient

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

With chronic alcohol abuse, do we become ketotic?

A

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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

With chronic alcohol abuse, what happens tour stomach?

A

ailments, ulcers, diarrhea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

With chronic alcohol abuse, what happens to our skin?

A

increased problems

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

With chronic alcohol abuse, what happens to sexual potency?

A

impotence, testicular atrophy, gynecomastia and testosterone drop

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

With chronic alcohol abuse, what happens tour heart?

A

cardiomyopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

With chronic alcohol abuse, what happens to coagulation?

A

defect– decreased coagulation proteins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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?

A

go down

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, edema3.Cancer
42
Q

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

A
  1. narcosis/drug2. other organ problems3. malnourished4. 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. increase2. CYP2E, CYP3A3.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?

A

yes

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 retardationsmaller heads and brainsabnormal facial featurespoor coordinationhyperactivity

52
Q

Alcoholism is a disease that includes what 4 symptoms?

A

cravingloss of controlphysical dependencetolerance

53
Q

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

A

> 14million8.1%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

tremorinsomniairritability

58
Q

What are the major symptoms of alcohol withdrawal?

A

anxietyagitationdiaphoresisdeliriumdisorientation

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?

A

Yes

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

methanolethylene 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?

A

NO!!!!

69
Q

Where can we find methanol?

A

antifreeze, paint remover

70
Q

Can methanol be absorbed through skin and lung exposure?

A

yes

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

glycoaldehydeglycolic 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?

A

acidosis

78
Q

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

A

Much lower