Alcohol Metabolism and Effects on the Liver

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Questions and Answers

What is the primary mechanism of absorption for alcohol in the body?

Facilitated Diffusion

Passive Diffusion (correct)

Endocytosis

Active Transport

Which condition is NOT associated with heavy alcohol use?

Lactic Acidosis

Ketonemia

Hyperglycemia (correct)

Hypoglycemia

How does alcohol primarily affect the liver over prolonged exposure?

Enhanced glucose metabolism

Reversible fat deposition (correct)

Increased bile production

Immediate necrosis

Which of the following is a characteristic effect of acute alcohol ingestion on the central nervous system?

CNS depression Signup and view all the answers

What distinguishes the metabolism of alcohol in women compared to men?

Lower gastric ADH and smaller volume of distribution Signup and view all the answers

What is the role of FOMEPAZOLE in alcohol metabolism?

Acts as a competitive inhibitor of alcohol dehydrogenase Signup and view all the answers

Which cardiovascular condition is commonly associated with heavy alcohol consumption?

Cardiomyopathy Signup and view all the answers

Which of the following is a common facial feature seen in individuals with fetal alcohol syndrome (FAS)?

Wide-set eyes Signup and view all the answers

What does PLUA stand for in the assessment of alcohol use disorder?

Positive Last Use Assessment Signup and view all the answers

What is one of the main behavioral symptoms of Alcohol Use Disorder?

Withdrawal Signup and view all the answers

Which drug class is commonly used to manage alcohol withdrawal symptoms?

Benzodiazepines Signup and view all the answers

What percentage of adults is considered at-risk drinkers for exceeding recommended alcohol limits?

30% Signup and view all the answers

How does acute alcohol exposure affect warfarin's anticoagulant properties?

Inhibits CYP2E1, enhancing warfarin's effect Signup and view all the answers

What is the effect of chronic alcohol use on warfarin's pharmacodynamics?

Reduces warfarin’s action Signup and view all the answers

Which drug is NOT used to prevent relapse in alcohol use disorder?

Benzodiazepines Signup and view all the answers

What contributes to the liver damage severity associated with chronic alcohol use and acetaminophen?

Production of NAPQI Signup and view all the answers

Study Notes

Alcohol Review

Absorption is passive diffusion, following a concentration gradient.
Distribution is proportional to water content in tissues.
Metabolism: 90-98% oxidation in the liver.
Excretion: small amounts in breath and urine.
Alcohol metabolism is zero-order kinetics due to limited liver capacity to convert NADH to NAD+.
Two inhibitors of alcohol metabolism are fomepizole and disulfiram, with specific mechanisms of action and clinical uses.
Heavy alcohol use can cause hypoglycemia, ketonemia, lactic acidosis, and hyperuricemia.
Alcohol's effects on the central nervous system (CNS) are characterized by depression, reduced anxiety, and disinhibition, with disturbed balance between excitatory and inhibitory influences.

Alcohol's Effects on the Liver

Initial effect is reversible fat deposition in hepatocytes.
Prolonged exposure can lead to hepatic steatosis (fatty liver), alcoholic hepatitis, and cirrhosis (irreversible).
Cirrhosis is characterized by fibrosis, liver dysfunction, and impaired circulation.
Women are more susceptible to liver damage.

Alcohol Impact on Other Systems

Gastrointestinal tract: can cause acute and chronic gastritis.
Hematopoietic system: anemia, thrombocytopenia, immune depression possible.
Cardiovascular system: cardiomyopathy, hypertension, hypothermia.
Facial features (FAS): individuals with FAS often have facial abnormalities and growth deficits, alongside central nervous system abnormalities.

Gender Differences in Alcohol Metabolism

Women are more vulnerable than men to alcohol's effects.
Women achieve higher blood alcohol concentrations due to factors like lower gastric ADH (alcohol dehydrogenase) and a smaller volume of distribution, leading to faster development of alcohol-related liver diseases.

Alcohol Use Disorder (AUD)

A major substance use disorder, characterized by behavioral and physical symptoms (withdrawal, tolerance, craving).
Average onset age is 21, with 14% of adults currently affected and 29% over a lifetime.
Associated with a threefold increase in early mortality. 30% of adults are considered at-risk drinkers.
Management often includes benzodiazepines for withdrawal, disulfiram, naltrexone, and acamprosate for relapse prevention.

Pharmacodynamic Interactions

Alcohol interacts with warfarin and acetaminophen through CYP2E1 modulation.
Acute alcohol exposure inhibits CYP2E1, amplifying warfarin's anticoagulant effect.
Chronic alcohol use induces CYP2E1, reducing warfarin's action.
For acetaminophen, alcohol's metabolism via CYP2E1 increases production of hepatotoxic metabolite NAPQI; chronic use exacerbates damage, and acute exposure may increase toxicity.

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Description

Explore the intricate processes of alcohol absorption, distribution, metabolism, and excretion. This quiz delves into the effects of alcohol on the liver, detailing the consequences of prolonged exposure and the mechanisms of inhibitors that affect metabolism. Test your knowledge on how alcohol impacts both liver function and the central nervous system.