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CLASP Alcohol > Alcohol and It's Effects > Flashcards

Alcohol and It's Effects Flashcards

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

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

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
Q

How does alcohol affect fatty acid oxidation and what are the effects

A

It impairs oxidation
Causes excess ketogenesis - leads to alcoholic ketoacidosis
Increased lipid synthesis - lay down more fat

26
Q

What is alcoholic ketoacidosis

A

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
Q

How does alcohol affect the brain

A

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
Q

Why does alcohol make you pee more

A

We often drink more fluid when drinking alcohol than we would soft drinks
Inhibits ADH which reduces water reabsorption

29
Q

Describe the effects of different alcohol levels (<100, 100-200, >200)

A

<100 - fun, disinhibited etc
100-200 - falling, slurred speech etc
>200 - dangerous, difficult to rouse

30
Q

What effect does alcohol have on the heart

A

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
Q

What is the proper name for a hangover headache and what causes it

A

Veisalgia Cephalgia
Mainly caused by dehydration
Other causes are the other substances in alcohol such as sulphites, phenols etc

32
Q

Are there any health benefits from alcohol

A

No
Large study has found that even small amounts bring no benefits
Main risk factor for death in 15-49 y/o

33
Q

What are the symptoms of mild alcohol withdrawal

A

Occurs 12-36 hrs from last drink

fine tremor, sweating, anxiety, hyperactivity, ^HR, ^BP, fever, anorexia, nausea, retching

34
Q

What are the symptoms of moderate alcohol withdrawal

A

Occurs 12hrs to 5 days after last drink

coarse tremor, shaking agitation, confusion, disorientation, paranoia, seizures (especially 24-48hrs), hallucinations

35
Q

What are the symptoms of severe alcohol withdrawal

A

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
Q

How do you manage alcohol withdrawal

A

Treat with diazepam
Regularly assess and alter dose
Provide supportive treatment

37
Q

What are the CNS effects of mild alcohol consumption

A

sedative, mild anaesthetic
activates reward centre
sense of well being, disinhibition, euphoria

38
Q

What are the CNS effects of alcohol intoxication

A

Increased risk of accidental injury
Elated, aggressive behaviours, drowsiness, slurred speech, unsteadiness
Loss of consciousness

39
Q

How does alcohol consumption cause seizures

A

Sudden cessation of alcohol can cause TC seizures

May also trigger seizures in existing epileptics

40
Q

How does alcohol affect the nerves and muscles

A

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
Q

What causes Wernicke-Korsakoff SYndrome

A

Thiamine deficiency which is common in alcoholics

Leads to cytotoxic oedema

42
Q

What are the symptoms of Wernicke-Korsakoff

A

Ocular dysfunction
Ataxic gait
Acute confusion

43
Q

How do you treat Wernicke-Korsakoff

A

Thiamine replacement

Urgent!

44
Q

What are the symptoms of Korsakoff syndrome

A

Anterograde amnesia - cant remember new info
Retrograde amnesia - episodic memory
Confabulation

45
Q

How can you treat Korsakoff syndrome

A

Abstinence and nutrition

chances of recovery low

46
Q

How is alcohol linked to dementia

A

50-70% of problem drinkers have global cognitive impairment
May kill some neurones

47
Q

What effect does alcohol have on the heart

A

Can cause dilated cardiomyopathy - impairs ventricular function
Arrhythmias - AF or SVT that usually resolve
Chronic electrolyte imbalance may cause OT

48
Q

What are the population trends of liver disease

A

5th most common cause of death in UK
Increasing hugely
One of the most common causes of premature mortality
Usually preventable

49
Q

What is alcohol related steatosis

A

hepatocytes swell with triglycerides - fat build up
almost always seen in heavy drinkers
Commonly presents with odd LFT
reverses with cessation

50
Q

Describe alcohol related hepatitis

A

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
Q

What can cirrhosis lead on to

A

portal hypertension
hepatocellular carcinoma
nutritional decline

52
Q

What are some consequences of portal hypertension

A

variceal bleeding
ascites
spontaneous bacterial peritonitis
hepatic encephalopathy

53
Q

What are potential treatments/ managements for cirrhosis

A 
Abstinence
Vitamins
Nutrition
Endoscopic
Pharmacological – Bblockers, lactulose, Rifaximin
Radiological – TIPPS
Surgical - Transplant
54
Q

What effect does alcohol have on cancer risk

A

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
Q

Name 4 key drugs for alcohol abstinence treatment

A

Acamprosate – reduces cravings
Naltrexone – reduces desire for alcohol
Disulfiram – aversion therapy drug
Nalmefene – opioid antagonist

CLASP Alcohol (6 decks)

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