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1LL3 - Alcohol metabolism
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Terms in this set (47)
Tobacco, inactivity, poor diet, harmful use of alcohol
What are the shared risk factors of non-communicable diseases?
1 per day
How many drinks per day for women? (moderation)
1-2 per day
How many drinks per day for men? (moderation)
Pregnant women, children and adolescents
Who should never drink alcohol?
Increased HDL, decreased LDL oxidation, decreased blood clotting, decreased platelet aggregation, decreased homocysteine, decreased cell aggregation
Moderate alcohol has what effects?
Increased acetaldehyde, increased oxidative stress, increased triglycerides, increased cell aggregation, increased reactive species
Excessive alcohol has what effects?
4+ in one sitting
How many drinks are considered binge drinking for women?
5+ in one sitting
How many drinks are considered binge drinking for men?
8+ per week
What is considered heavy drinking for women?
15+ per week
What is considered heavy drinking for men?
Alcohol dehydrogenase enzyme in the cytosol of the liver
What is ethanol metabolized by?
Acetaldehyde
What is a toxic by-product of alcohol metabolism?
Acetaldehyde dehydrogenase converts the toxin in the mitochondria to non-toxic acetate which can be used by muscle and other tissues as fuel (converted to Acetyl CoA)
What converts toxic acetaldehyde to a non-toxic form?
Because of its toxic properties
Why does the liver metabolize alcohol first?
Microsomal ethanol oxidizing system (part of the cytochrome P450 system of enzymes)
What does MEOS stand for?
Embedded in the membrane of the endoplasmic reticulum, they are inducible
Where are the enzymes from the MEOS system found?
When high levels of alcohol are consumed
When is the MEOS system used?
Generates free radicals, can interfere with drug metabolism
What are the issues associated with use of the MEOS system?
With normal levels of alcohol consumption
When is ALDH used?
Alcohol is metabolized preferentially by the cytochrome P450 enzymes, and therefore the drugs will build up in the body to toxic levels
Why can alcohol and sedative drugs in combination kill you?
Acetaminophen uses other pathways to be excreted from the body, you will get accelerated metabolism of the tylenol, and this can lead to destruction of the liver
What is the issue with drinking and taking acetaminophen?
Cytochrome P450 enzymes
Which pathway helps get rid of sedative drugs?
After one episode of binge drinking
How early can fat deposits be seen in the liver?
Cirrhosis of the liver
What does chronic abuse of alcohol lead to?
Oxidation of alcohol in the liver cells causes the NAD+/NADH ratio to rise, Alcohol increases lipolysis but fatty acid oxidation is inhibited by the NADH so fats build up in the liver
How do these fatty streaks in the liver arise?
Frontal lobe, midbrain, cerebellum, medulla and pons
Which areas of the brain are affected by increased alcohol consumption?
Judgement
What does the frontal lobe control?
Speech and vision centres
What does the midbrain control?
Hand-eye coordination and voluntary muscle function
What does the cerebellum control?
Heart and respiration, consciousness
What does the medulla/pons control?
Semi-consciousness/unconsciousness, slow respiratory rate (<8 breaths per minute), cold/clammy/bluish skin
What are symptoms of alcohol poisoning?
2 drinks - impaired judgement, altered mood, relaxed inhibition/tension and increased heart rate
Blood alcohol level 0.05 - # of drinks and effect on CNS
4 drinks - impaired coordination, delayed reaction time, impaired peripheral vision
Blood alcohol level 0.10 - # of drinks and effect on CNS
6 drinks - unrestrained behaviour, slurred speech, blurred vision, staggered gait
Blood alcohol level 0.15 - # of drinks and effects on the CNS
8 drinks - double vision, inability to walk, lethargy
Blood alcohol level 0.20 - # of drinks and effects on the CNS
12 drinks - stupor, confusion, coma
Blood alcohol level 0.30 - # of drinks and effects on the CNS
> or equal to 14 - unconsciousness, shock, coma, death
Blood alcohol level 0.35-0.60 - # of drinks and effects on the CNS
0.5 oz
How many ounces of ethanol in each drink?
Ratio of NADH is increased which has diverted pyruvate to lactate, caused production of ketone bodies and prevented gluconeogenesis. Alcohol promotes lipolysis, lipids to the liver made to Acetyl CoA, no where to go and they become ketone bodies which add to the acidosis
Why would a person be found semi-conscious at the bottom of a flight of stairs with their blood alcohol slightly elevated but with low blood pH and low blood glucose?
They would be higher, with cells being damaged, normally these transferases would be found inside the cell, however with the damage they would now be found in the blood
In someone with liver damage, would levels of ALT and AST be higher or lower in the blood?
Increased ammonia/ammonium and decreased albumin
Which substances would be higher or lower in the body if there was damage to the liver?
Sedative - cytochrome P450, Tylenol - other pathways
Which pathways used by sedative drugs and drugs like tylenol?
Pitting edema, no protein to hold fluid within the cells
What sign do we get without albumin?
Transferrin and blood coagulation proteins
What other substances does the liver make?
Alcoholic hepatitis and steatosis (fatty liver)
Which conditions of the liver can be reversed?
Liver fibrosis and cirrhosis
Which conditions of the liver cannot be reversed?
Acetaldehyde binds to glutathione (endogenous antioxidant) and MEOS produces more free radicals, impaired protein secretion and fat is stuck in the liver, ALT/AST swell in the liver
Alcohol induced hepatitis
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