S59 - Drug and alcohol

Question 1

80% of alcohol is metabolized by alcohol dehydrogenase to form acetyl aldehyde which is further metabolized by alaldehyde dehydrogenase

Answer 1

True

Forms Acetyl CoA and Acetate

Acetate –> citric acid cycle –> CO2 / water

Question 2

Alcohol has shown to be associated with > 60 different medical conditions.

Answer 2

true

Question 3

Typical drink has 12 gms of EtOH.

Answer 3

true

Question 4

Liver cancer 2-1
Oralpharageal 2-1
Stroke 18-1
Motor vehicle 3-1

Incidence men higher than women

Answer 4

true

Question 5

Consumption of > 70 gm/day has a higher risk of CHD than the other 2 groups. Accelerates quickly.

Answer 5

true

Question 6

Compared to non-drinkers, low-to-moderate drinkers (< 20 gm/day) have a lower risk of CHD. Cardioprotective effect (1 glass red wine…).

Answer 6

true

Question 7

Differences between “developing” countries and “developed” countries.

Answer 7

Cancer and CHD incidences are lower in developing countries (they have other problems).

Question 8

12 gm EtOH average drink (12 oz beer; 4 oz wine; 1.5 oz shot 80 proof).

Answer 8

true

Question 9

Alcohol-Related Medical Conditions

Answer 9

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

Question 10

Alcoholic-Liver Disease (ALD). Three major conditions –

Answer 10

fatty liver disease;
alcoholic hepatitis;
cirrhosis.

Question 11

Fatty liver present > 90%, smaller amount progress to alcoholic hepatitis (10-20%) and then => cirrhosis (15%).

Answer 11

true

Question 12

Alcohol-Related Medical Conditions

Vitamins A, C, E, and selenium are depleted.

Answer 12

true

Question 13

Alcohol-Related Medical Conditions
Vitamin B1 (thiamine): Wernicke’s encephalopathy. Routine use for all patients. B3 and B6 (-) also contributes.

Answer 13

true

Question 14

Alcohol-Related Medical Conditions
Vitamin B12: megaloblastic anemia and folate (-).
Folate (-) => Vitamin K decrease => bleeding increase.

Answer 14

true

Question 15

Alcohol-Related Medical Conditions

Vitamin D: decrease bone density and mass.

Answer 15

true

Question 16

Tobacco and smoke contains 6,700 compounds, 63 are known carcinogens and 11 are definite human carcinogens.

Answer 16

true

Question 17

Three main areas of medical conditions associated with tobacco – CHD, cancer and pulmonary.

Answer 17

true

Question 18

Tobacco-Related Medical Conditions

Answer 18

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)

Question 19

Waterpipe smoking is just as “bad” as cigarettes/cigars.

E-cigarettes: Data coming in – it is alarming!

Answer 19

true

Does it really help people to stop smoking?

Question 20

E-cigs, CDC Reports – most commonly used tobacco product among youth (12-17 yrs).

Answer 20

true

Question 21

E-cigarettes: > 2 million (2016) middle and high school used < 30 days

Answer 21

true

Question 22

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

Answer 22

true

Question 23

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.

Answer 23

true

Question 24

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

Answer 24

true

Question 25

Alcohol and tobacco products have been with humans for a few “thousand” years.

Answer 25

true

Question 26

Which days of the week does most of the alcohol-related driving accidents occur?

Answer 26

Saturday night into Sunday morning.

Question 27

What organ systems are affected with long-term alcohol use?

Answer 27

Cardiovascular, Hepatic, GI, CNS

Question 28

Which nicotine delivery method has the fastest time onset of plasma nicotine concentrations?

Answer 28

E-cigarettes