Term
| What are the 3 alcohols to worry about and what are their important downstream products? What enzymes do they rely on? |
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Definition
1. Ethylene glycol (antifreeze)-->oxalic acid
2. Methanol (wood grain)-->formaldehyde-->formic acid
3. Ethanol-->acetaldehyde-->acetic acid
-Each has a first step which uses the same **alcohol dehydroginase and **NAD+ to create an aldehyde
-Second steps use various *aldehyde dehydroginases and **NAD+ to yield **acids (**metabolic acidosis) |
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Term
| Overall how do alcohols effect the CNS? |
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Definition
-They have a GABA mimetic effect causing CNS depression
-Also all cause metabolic acidosis from end products |
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Term
| Whats the danger with ethylene glycol? Treatment? |
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Definition
-Oxalic acid crystals tear up kidney causing ATN (acute tubular necrosis), and also severe metabolic acidosis
-Traditionally treated with ethanol, but now we use **fomepizole which is a long acting AD inhibitor
-Can also throw in hemodialysis if needed |
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Term
| Whats the danger with methanol? Treatment? |
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Definition
-Formaldehyde causes cell damage, and formic acid causes *severe anion gap metabolic acidosis
-The cell damage is especially apparent in the kidneys and **eyes (blindness)
-Also treat with fomepizole |
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Term
| Go through ethanol issues? (use diagram on 144) |
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Definition
-Connection between NADH and lactic acidosis
-Connection between thiamine, carbohydrates, fatty liver, hyperosmolar injury, etc. |
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Term
| What drug was used to intentionally give alcoholics hangovers? |
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Definition
-Disulfiram-->inhibits acetaldehyde dehydrogenase
-Acetaldehyde is responsible for hangovers |
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Term
| What are the disulfiram analogs used today? |
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Definition
-**Metronidazole (and any other **"-azole" antibiotics)
-Cefoperazone
-Cefotetan
-Chlorpropamide
-Griseofulvin (antifungal)
-Must advise patients on these not to drink |
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Term
| #1 cause of mental retardation? |
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Definition
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