Chp 3 Sl Alcohol

8/8/2019 Chp 3 Sl Alcohol

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A Small Dose of Alcohol 2/16/04

An Introduction To TheHealth Effects of Alcohol

A Small Dose of Alcohol


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A Small Dose of Toxicology A Small Dose of Alcohol 2/16/04

What Is This?

CH

H

H

OHC

H

H

(CH3-CH2-OH)


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Ethanol

CH

H

H

OH

Ethyl Alcohol

C

H

H


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Methanol

CH

H

H

OH

Methyl Alcohol


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Beer 10,000 years ago accident from grain?1100 AD guild formed devoted to brewing1722 a nourishing drink for potters andlaborers created called Potter

Wine8 ,000 years ago

5,000 years ago the vineyards2,000 BC - Hammurabi ruler of Babylon setsrules for the sale and purchase of wine1,500 BC Greek god of wine Dionysus /

Bacchus

Historical Development


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AlcoholAlchemist of the 16th century saw alcoholas the essence from distillation.The middle of the 1 8 th century alcohol tookon its current meaning of the intoxicating

ingredient of many common beverages.

Historical Awareness


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"You will conceive and bear a sonnowthen be careful to take no wine or strong drink and to eat nothingunclean".

Bible - Judges 13:3-4

Ancient Awareness


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T is not the drinking that is to beblamed, but the excess.

John Selden (15 8 41654)

In Table Talk 16 89

Historical Perspective


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Alcohol is the number one drug of choice among our Nations youth. Yet the

seriousness of this issue does notregister with the general public or policymakers.

Enoch Gordis, M.D. Director, National Instituteon Alcohol Abuse and Alcoholism.

Current Views


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Production of Alcohol

Fermentation Sugar to Alcoholand Carbon dioxide

C6H12O6 2(CH 3-CH2-OH) + 2CO 2


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7.4% of adult population in U.S. alcoholic

$18

5 Billion cost of alcohol abuse in U.S.100,000 deaths annual in U.S. related to$1.2 Billion spent on wine, beer and liquor advertisements in U.S.

Some Current Facts


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Fetal Alcohol Syndrome (FAS)

Most common preventable cause of adverse CNS development

4,000-12,000 infants per year in US

Characteristics

Growth retardationFacial malformationsSmall head

Greatly reduce intelligence


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Fetal Alcohol Syndrome (FAS)

1 to 3 births per 1,000 world wide??

19 68 first association by Frenchresearchers at the University of Nantes

Early 1 9 70s FAS as condition Universityof Washington, Seattle WA, USA



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Fetal Alcohol Effect (FAE)

Milder form of FAS


CharacteristicsGrowth deficiency

Learning dysfunctionNervous systems disabilities


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A Small Dose of Toxicology A Small Dose of Alcohol 2/16/04FAS Child (National Geographic, George Steinmetz, Feb 1992)


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Consumption

Have you ever drankalcohol?Why?

Have you ever dranktoo much alcohol?


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Health Effects

What are the pleasanteffects of alcohol?

The adverse effects(toxicity)?


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CNS DepressantDepression of inhibitory controlVasodilation, warm, flushed, reddish skinEmotional outburstsDecreased memory & concentrationPoor judgment

Decreased reflexesDecreased sexual response

Acute Effects


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ObviousAlcoholism, death, cancer (oral cavity,esophagus, liver), fetal effects (FAS)

AlcoholismCirrhosis of liver, appetite loss, poor

judgment

SubtleLost productivity, impaired performance,motor impairment, cost to society

Long Term Adverse Effects


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Alcohol & Cancer

Ethanol consumption increasesrisk of cancer

Oral CavityPharynx and Larynx

EsophagusLiver


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Rapidly absorbed from stomach,small intestine, and colonMaximal blood concentration within30 to 9 0 minutesCan be absorbed through the lungs

Absorption


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Uniformly distributed throughouttissues and body fluidsReadily crosses placenta, toexposure fetus

Distribution


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Urinary ExcretionExhalationMetabolism

Elimination


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Metabolism I

CH OH

Ethanol

H

H

C

H

H

CH

H

H

C O

H

=

Acetaldehyde(ADH Alcohol Dehydrogenase)

ADH


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Metabolism II

CH

H

HC OH

=

Acetaldehyde(ALDH Acetaldehyde Dehydrogenase)

ALDH

Acetate

CH

H

HC OOH

=


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Metabolism III

8 0-9 0% Metabolized

Rate is constant (not increasedby concentrations in the blood)About 30 ml (1 oz) in 3 hours


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Gender Differences

Females higher blood alcohol levelsthan males

Males have higher stomachmetabolism of alcohol than females


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Genetic Variation in ALDH

Acetaldehyde Dehydrogenase (ALDH)varies in Caucasians, Blacks and Asians.

50% of Asians have inactive ALDH

Elevated acetaldehyde cause increased

flushing, tachycardia (elevated heart rate),nausea, vomiting & hyperventilation.

Disulfiram inhibits ALDH


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Alcoholism Alcohol Dependence

Characterized by the following:

Craving: A strong need, or compulsion, to drink.Loss of control: The inability to limit ones drinking

on any given occasion.Physical dependence: Withdrawal symptoms, suchas nausea, sweating, shakiness, and anxiety, occur when alcohol use is stopped after a period of heavydrinking.Tolerance: The need to drink greater amounts of alcohol in order to get high.

(from: U.S. Alcohol & Drug Information - http://ncadi.samhsa.gov/)


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Alcoholism Alcohol Dependence

Approximately 14 million Americans7.4 percent of thepopulation meet the diagnostic criteria for alcohol

abuse or alcoholism

(from: U.S. Alcohol & Drug Information - http://ncadi.samhsa.gov/)


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Tremor Nausea

IrritabilityAgitationTachycardiaHypertensionSeizersHallucinations

Alcohol Withdrawal Effects


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Ethanol as Antidote

Antidote for Poisoning by:Methanol

Ethylene glycolDiethylene glycol

Inhibits metabolic activation byalcohol dehydrogenase (ADH)


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198 1 - U.S. Surgeon General first advised thatwomen should not drink alcoholic beveragesduring pregnancy.

1988 - U.S. requires warning labels on allalcoholic beverages sold in the United States.

199 0 - U.S. Dietary Guidelines state that womenwho are pregnant or planning to become

pregnant should not drink alcohol.

1998 - 19 states require the posting of alcoholhealth warning signs where alcoholic beveragesare sold

Regulatory Status


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A Small Dose of Alcohol


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Additional Information

Web SitesEngland Department of Health (DOH) Alcohol

Misuse Information. Online. Available HTTP:(accessed: 1 April 2003).

Health Canada Fetal Alcohol Syndrome and FetalAlcohol Effect. Online. Available HTTP:(accessed: 2 April 2003).


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Authorship Information

For Additional Information Contact

Steven G. Gilbert, PhD, DABTE-mail: [email protected]: www.asmalldoseof.org

This presentation is supplement toA Small Dose of Toxicology

Documents

Chp 3 Sl Alcohol