Lec 14 - Alcohol

What is alcohol processing like?

Absorbed in the stomach and small intestine

Bio-transformed by the liver

• Acetaldehyde is the more toxic version

• Acetate can then be excreted by the kidney

how does alcoholic fatty liver disease happen - the processing?

Higher Dehydrogenase Activity

• Higher NADH

• Triggers formation of fatty acids •

  • Steatosis

  • Results in Alcoholic Fatty Liver disease

What is liver toxicity?

Impaired function

• spirals badly

What is alcoholic liver disease (ALD)?

Alcohol-induced hepatitis

• Excess biotransformation / inflammation

Alcohol effects on liver?

Fatty liver

• Fat deposits in hepatocytes

Alcoholic hepatitis

• jaundice

Cirrhosis

Liver cancer

What is thiamin?

B1 vitamin

• Needed to activate steps in the metabolic pathways

  • E.g. Activates Pyruvate Dehydrogenase

    • Needed for aerobic respiration

What is effect on thiamin from alcohol?

Alcohol processing will divert Thiamin away from the metabolic pathways and into the acetaldehyde pathways

• Thiamin deficiency

What are effects of chronic alcohol abuse? (8)

Increased risk for

• Liver disease

• Cardiovascular disease

• Cancer

• Pancreatitis

• Type II Diabetes

• Neurological disorders

• Korsakoff’s syndrome (memory disorder – thiamin deficiency)

• Death

What medical problems happen to digestive system with alcohol? (40

oral cavity cancer

esophageal cancer

esophageal varices

• Changes in Liver - portal pressures

  • Causes GI bleeding

Pancreatitis

All made worse when combined with smoking!!!!!

Cardiovascular problems with alcohol? (5)

Atrial fibrillation

Hypertension

Strokes

Cardiomyopathy

Heart failure

Kidney problems?

Must secrete acetate

• Can lead to kidney failure

• Kidney inflammation

  • Blocked ducts

ADH inhibited

• High excretion of water - Dehydration

Can lead to acid-base imbalanc

Nervous problems? (8)

• acute intoxication with loss of consciousness

• Withdrawal

• Seizures

• subdural haemorrhage

• peripheral neuropathy

• Wernicke-Korsakoff syndrome

  • Low thiamin

• cerebellar degeneration

• Balance problems

What is fetal alcohol syndrome? effects? (7)

alcohol consumption in pregnancy affecting

• no amount is safe

1. Reduced brain size

2. Low body weight

3. Poor coordination

4. Small head size

5. Hyperactive behavior

6. Attention deficit

7. Poor memory

Endocrine effects?

Suppresses the CNS

• decreased hormone release from Pituitary and Hypothalamus

Results in

• Decreased thyroid hormone (decreased metabolism)

• Decreased cortisol

• Decreased growth hormone and cell repair

• Poor water balance (ADH effects)

• Possible reproductive effects long-term (FSH/ LH)

  • Testosterone / estrogen effects ⬧

  • Secondary sex characteristics

blood effects?

Alcohol causes a thinning of the blood

Vasodilates the arterioles

• Face becomes flushed

• Can affect thermoregulation (lose heat faster)

metabolic effects?

Decreased ATP production

• Thiamin deficiency

  • Due to alcohol biotransformation

• Results in poor glucose metabolism

  • Lack of TPP

  • Slows pyruvate dehydrogenase – less ATP

• can cause permanent metabolic dysfunction

Respiratory effects?

Breathing is suppressed at the medulla

• Decreased blood oxygen

  • Affects cell function

Reduced breathing – CO2 levels rise

• Respiratory acidosis

If vomit is aspirated – risk of aspiration pneumonia or respiratory infections

skin effects?

With ADH inhibited – body (and skin) becomes dehydrated

• More wrinkles

Also causes skin inflammation and rashes

• Acetaldehyde effect

Psychiatric problems?

1. Alcohol dependence syndrome

2. Suicidal ideation

3. Depression

4. Anxiety

5. Anti-social behaviour

6. Impaired work performance

miscellaneous problems?

Loss of libido

Impotence

• Erectile dysfunction

Fetal alcohol syndrome

Relationship problems

Violent crimes