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CLASP Alcohol > Alcohol and It's Effects > Flashcards

Alcohol and It's Effects Flashcards

(55 cards)

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1
Q

What is alcohol

A

Any organic liquid with hydroxyl (-OH) group(s)

It can be considered a drug

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2
Q

Where is methanol found

A

In de-icer and other chemicals

May be produced in contaminated home brews and counterfeit alcohol

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3
Q

What are the effects of methanol

A

It has similar depressant properties to ethanol and people will appear drunk
It is highly toxic
Leads to acidosis and blindness
Causes methanol poisoning

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4
Q

How is methanol metabolised

A

Becomes formaldehyde and then formic acid

This causes the acidosis

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5
Q

How do you treat methanol poisoning

A

Give them ethanol (whiskey etc) as it competitively inhibits the alcohol dehydrogenase and reduces methanol metabolism
Also put on dialysis to clear the methanol

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6
Q

What is the recommended alcohol intake per week

A

No more than 14 units

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7
Q

What is the type of alcohol found in drinks

A

Ethanol

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8
Q

What are common signs of alcohol withdrawal

A

Aggression
Seeing spiders
Seen after surgery due to fasting etc

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9
Q

Where is alcohol mainly absorbed

A

The small bowel

Limited in the stomach

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10
Q

How is alcohol digested in the stomach

A

By alcohol dehydrogenase

This is limited

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11
Q

How does food help reduce alcohol absorption

A

Slows gastric emptying (time to digest) which gives alcohol slightly more time to be metabolised
This means less is absorbed in small bowel

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12
Q

What type of drink is absorbed fastest

A

Aerated drinks like champagne

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13
Q

Which drugs increase alcohol absorption

A

antihistamines and metaclopramide

Anything that increases rate of gastric emptying

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14
Q

How are spirits processed by the body

A

They delay emptying due to irritation of the gastric mucosa

Absorbed slower

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15
Q

Why do women have lower alcohol tolerance (usually)

A

On average they have lower circulating blood volumes which means less volume to dilute the alcohol
Also the have lower alcohol dehydrogenase levels
And less lean body mass

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16
Q

Where does alcohol metabolism occur

A

90% in the liver
Small amounts in the brain and pancreas
5% excreted in breath - basis for breathalyser

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17
Q

How is alcohol metabolised

A

Broken down by alcohol dehydrogenase to acetaldehyde
Then metabolised to acetate by acetate dehydrogenase
Further broken down into CO2 and H20

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18
Q

Which compound is responsible for hangovers

A

Acetaldehyde

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19
Q

At what rate is alcohol removed from the body

A

Roughly 1 unit per hour

15mg/100ml/hour

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20
Q

Which ethnic groups struggle to metabolise alcohol and why

A

Inuits, Eskimos and aborigines due to low alcohol dehydrogenase levels
50% of Japanese people lack it completely
Leads to more unpleasant side effects: flushing, nausea and headache

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21
Q

Is it possible to build tolerance for alcohol

A

Yes
It’s possible to up regulate alcohol dehydrogenase
In heavy drinkers other metabolism pathways can be activated such as CP450

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22
Q

How does alcohol affect the Krebs cycle

A

It inhibits it which switches to anaerobic metabolism

This produces lactic acid faster - sore muscles

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23
Q

What is hepatic gluconeogenesis

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A

When blood glucose is low, the glycogen stores in the liver are converted into glucose to increase the levels

24
Q

How does alcohol affect hepatic gluconeogenesis and what is the result

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A

It inhibits the process so new glucose isn’t made

This is why you get hungry when drunk as the body is trying to get more sugar

25
How does alcohol affect fatty acid oxidation and what are the effects
It impairs oxidation Causes excess ketogenesis - leads to alcoholic ketoacidosis Increased lipid synthesis - lay down more fat
26
What is alcoholic ketoacidosis
Excess ketone production due to impaired fatty acid metabolism, excess NADH and often a fasting state Low or normal blood sugar with high ketones
27
How does alcohol affect the brain
Increases levels of GABBA - CNS depressant Affects: cortex - disinhibition, limbic system - memory loss,confusion, cerebellum - loss of coordination and slurring, reticular formation - consciousness and the lower brain stem - breathing and blood pressure
28
Why does alcohol make you pee more
We often drink more fluid when drinking alcohol than we would soft drinks Inhibits ADH which reduces water reabsorption
29
Describe the effects of different alcohol levels (<100, 100-200, >200)
<100 - fun, disinhibited etc 100-200 - falling, slurred speech etc >200 - dangerous, difficult to rouse
30
What effect does alcohol have on the heart
It's a negative into rope - reduces force of contraction Heart beats faster to compensate Occasionally get Holiday Heart Syndrome after lots of binge drinking which is a supraventricular tachycardia caused by the alcohol, it often gets better itself
31
What is the proper name for a hangover headache and what causes it
Veisalgia Cephalgia Mainly caused by dehydration Other causes are the other substances in alcohol such as sulphites, phenols etc
32
Are there any health benefits from alcohol
No Large study has found that even small amounts bring no benefits Main risk factor for death in 15-49 y/o
33
What are the symptoms of mild alcohol withdrawal
Occurs 12-36 hrs from last drink | fine tremor, sweating, anxiety, hyperactivity, ^HR, ^BP, fever, anorexia, nausea, retching
34
What are the symptoms of moderate alcohol withdrawal
Occurs 12hrs to 5 days after last drink | coarse tremor, shaking agitation, confusion, disorientation, paranoia, seizures (especially 24-48hrs), hallucinations
35
What are the symptoms of severe alcohol withdrawal
Occurs 12hrs to 7+ days more severe and prolonged, risk of DTs around 48 hrs – severe agitation, anxiety, confusion, delusions, hallucinations (tactile visual – crawling beesties). Circulatory collapse and death can occur
36
How do you manage alcohol withdrawal
Treat with diazepam Regularly assess and alter dose Provide supportive treatment
37
What are the CNS effects of mild alcohol consumption
sedative, mild anaesthetic activates reward centre sense of well being, disinhibition, euphoria
38
What are the CNS effects of alcohol intoxication
Increased risk of accidental injury Elated, aggressive behaviours, drowsiness, slurred speech, unsteadiness Loss of consciousness
39
How does alcohol consumption cause seizures
Sudden cessation of alcohol can cause TC seizures | May also trigger seizures in existing epileptics
40
How does alcohol affect the nerves and muscles
Can cause peripheral neuropathy - pain and weakness Compression neuropathy - temporary damage to myelin sheath that usually resolves itself Myopathy can occur acutely after binges or chronically - muscle pain and weakness
41
What causes Wernicke-Korsakoff SYndrome
Thiamine deficiency which is common in alcoholics | Leads to cytotoxic oedema
42
What are the symptoms of Wernicke-Korsakoff
Ocular dysfunction Ataxic gait Acute confusion
43
How do you treat Wernicke-Korsakoff
Thiamine replacement | Urgent!
44
What are the symptoms of Korsakoff syndrome
Anterograde amnesia - cant remember new info Retrograde amnesia - episodic memory Confabulation
45
How can you treat Korsakoff syndrome
Abstinence and nutrition | chances of recovery low
46
How is alcohol linked to dementia
50-70% of problem drinkers have global cognitive impairment May kill some neurones
47
What effect does alcohol have on the heart
Can cause dilated cardiomyopathy - impairs ventricular function Arrhythmias - AF or SVT that usually resolve Chronic electrolyte imbalance may cause OT
48
What are the population trends of liver disease
5th most common cause of death in UK Increasing hugely One of the most common causes of premature mortality Usually preventable
49
What is alcohol related steatosis
hepatocytes swell with triglycerides - fat build up almost always seen in heavy drinkers Commonly presents with odd LFT reverses with cessation
50
Describe alcohol related hepatitis
Acute, life threatening manifestation Cell damage & inflammation Presents with jaundice, coagulopathy, liver failure High risk of renal failure, bleeding, infections high mortality only hope is abstinence and nutrition
51
What can cirrhosis lead on to
portal hypertension hepatocellular carcinoma nutritional decline
52
What are some consequences of portal hypertension
variceal bleeding ascites spontaneous bacterial peritonitis hepatic encephalopathy
53
What are potential treatments/ managements for cirrhosis
``` Abstinence Vitamins Nutrition Endoscopic Pharmacological – Bblockers, lactulose, Rifaximin Radiological – TIPPS Surgical - Transplant ```
54
What effect does alcohol have on cancer risk
Increases it Oral, pharyngeal, laryngeal, oesophageal, colorectal, hepatocellular carcinoma, female breast cancer This is due to carcinogenic metabolites and may be linked to increased oestrogen
55
Name 4 key drugs for alcohol abstinence treatment
Acamprosate – reduces cravings Naltrexone – reduces desire for alcohol Disulfiram – aversion therapy drug Nalmefene – opioid antagonist

CLASP Alcohol (6 decks)

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