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  1. 1. ALCOHOL
  3. 3. True or False? Alcohol Slows Down Your Body and Mind.
  4. 4. <ul><li>TRUE!!! </li></ul><ul><li>Depressant. </li></ul><ul><li>Leaves you unable to think, react, and make decisions as you normally would. </li></ul>
  5. 5. True or False? You Feel Alcohol’s Effects Right Away.
  6. 6. <ul><li>TRUE!!! </li></ul><ul><li>Absorbed into bloodstream very quickly (within 5-10 minutes). </li></ul><ul><li>Passes from stomach directly into bloodstream. </li></ul><ul><li>Affects every organ, including brain. </li></ul>
  7. 8. People who have developed dependence on alcohol are called ALCOHOLICS .
  8. 9. Alcoholism <ul><li>Disease in which a person has physical or psychological dependence on drinks that contain alcohol. </li></ul><ul><li>Characterized as an impaired ability to study, work, or socialize normally. </li></ul>
  9. 10. Alcohol Dependence <ul><li>Characterized by the following: </li></ul><ul><li>Craving: A strong need, or compulsion, to drink. </li></ul><ul><li>Loss of control: The inability to limit one’s drinking on any given occasion. </li></ul>
  10. 11. <ul><li>Physical dependence: Withdrawal symptoms, such as nausea, sweating, shakiness, and anxiety, occur when alcohol use is stopped after a period of heavy drinking. </li></ul><ul><li>Tolerance: The need to drink greater amounts of alcohol in order to “get high.” </li></ul>
  11. 12. Blood Alcohol Concentration <ul><li>Amount of alcohol in a person’s bloodstream </li></ul><ul><li>legal limit acc to IL is .08% for people 21 years and older </li></ul><ul><li>& is zero for people under 21 </li></ul>
  12. 13. THE BRAIN
  13. 14. <ul><li>Neuronal depressant. </li></ul><ul><li>Small doses – euphoria , relief of anxiety, loss of social inhibitions & moods and feelings are altered. </li></ul><ul><li>Moderate dose – impair muscular co-ordination & visual acuity -driving dangerous. </li></ul><ul><li>Higher dose – mental clouding, impaired judgment, drowsiness & loss of self control. </li></ul>
  14. 15. <ul><li>High doses-stupor, coma& death </li></ul><ul><li>Sleep architecture-disorganized, sleep apnoea </li></ul><ul><li>Precipitates convulsions </li></ul><ul><li>Tolerance on long-term use </li></ul>
  15. 16. <ul><li>Damages Frontal, Temporal lobes, </li></ul><ul><li>Hippocampus </li></ul><ul><li>Decreases the no of dendrites </li></ul><ul><li>and axons </li></ul><ul><li>Increases Ventricle Size </li></ul><ul><li>Decreases blood flow </li></ul>
  16. 17. <ul><li>Wernicke-Korsakoffs Syndrome- ophthalmoplegia,ataxia,delirium,stupour. Psychosis,polyneuritis,insomnia etc </li></ul><ul><li>Other Psychological and Psychiatric problems </li></ul>
  17. 19. THE LIVER
  18. 20. <ul><li>Liver suffers more than any other organ. </li></ul><ul><li>Liver is responsible for filtering alcohol. </li></ul><ul><li>Excess calories are stored in liver as fat. </li></ul>
  19. 21. <ul><li>Can only oxidize about 1 serving of alcohol an hour </li></ul><ul><li>NO WAY to speed up this process </li></ul><ul><li>Until liver has had time to oxidize all of the alcohol ingested, it keeps circulating through the bloodstream </li></ul>
  20. 22. Healthy Liver Alcoholic Liver
  21. 23. <ul><li>Chronic consumption accumulation of fat-fatty degeneration & cirrhosis. </li></ul><ul><li>CIRRHOSIS </li></ul><ul><ul><li>scarring of liver </li></ul></ul><ul><ul><li>no blood flow in scarred area </li></ul></ul>
  22. 24. <ul><ul><li>liver cannot function </li></ul></ul><ul><ul><li>symptoms: high blood pressure, abdominal swelling, jaundice </li></ul></ul><ul><ul><li>IRREVERSIBLE </li></ul></ul>
  23. 27. <ul><li>Heart/Blood Vessels </li></ul><ul><ul><li>Small doses-Perspiration vasodilation-skin becomes flushed, feeling of warmth. </li></ul></ul><ul><ul><li>Moderate doses-tachycardia, mild rise in BP- muscular activity & sympathetic stimulation. </li></ul></ul>
  24. 28. <ul><li>Large doses-myocardial & vasomotor depression- BP </li></ul><ul><li>Chronic alcoholism-HTN & cardiomyopathy </li></ul><ul><li>Atrial fibrillation & other cardiac arrhythmias may occur due to conduction defects & Q-T prolongation. </li></ul>
  25. 29. THE STOMACH
  26. 30. <ul><li>Stomach </li></ul><ul><ul><ul><li>15-20% absorbed here Short Term- </li></ul></ul></ul><ul><ul><ul><li>Stomach acids increase, - nausea, vomiting, mucosal congestion & gastritis </li></ul></ul></ul><ul><ul><li>Long Term- </li></ul></ul><ul><ul><li>Chronic gastritis, ulcers & risk of stomach cancer </li></ul></ul>
  27. 32. THE PANCREAS <ul><li>Increased concentration of Pancreatic enzymes </li></ul><ul><li>Decreased volume of enzyme secretion </li></ul><ul><li>Pancreatitis </li></ul><ul><li>Decreased insulin production – </li></ul><ul><li>Secondary Diabetes </li></ul>Bleeding Pancreas of an Alcoholic, he’s now dead!
  28. 33. Pyloric Valve- Spasms in the presence of large amounts of ethanol Small Intestine- Majority of Ethanol absorbed here Damages Mucosal Cells, Villi, and Microvilli Decreases absorption of nutrients and vitamins Increases Triglyceral and Cholesterol production
  29. 34. <ul><li>Gall Bladder </li></ul><ul><li>Decreased amounts of Bile Secretion </li></ul><ul><li>Large Intestine </li></ul><ul><li>Decreased water and vitamin absorption </li></ul><ul><li>-Diarrhoea </li></ul>
  30. 35. <ul><li>Alcohol can even cause skin problems such as acne and splotchy skin. </li></ul>eeew!
  31. 36. BLOOD CHANGES RBC Decreased Production-Anemia WBC Decreased production Decreased response time more infections Increased risk for STD’s/HIV
  32. 37. <ul><li>Platelets </li></ul><ul><li>Decreased production </li></ul><ul><li>Decreased clotting time </li></ul><ul><li>More bumps and bruises </li></ul><ul><li>Endocrine Effects </li></ul><ul><li>Inhibits Vasopressin release </li></ul><ul><li>Decreases thyroid hormones, </li></ul><ul><li>progesterone, testosterone, </li></ul><ul><li>Luteinizing hormone, and others </li></ul>
  33. 38. Males Damages or kills Leydig Cells Increases feminine characteristics Decreased sexual drive, reproductive failure, impotence Females Early Menopause Premenstrual discomfort Increased menstrual Flows Infertility
  34. 39. Skeletal Muscle Di srupts internal structure of muscle Cramps, pain, weakness  Alcoholic Myopathy
  35. 40. FOETAL ALCOHOL SYNDROME <ul><li>Most common preventable cause of adverse CNS development </li></ul><ul><li>Characteristics </li></ul><ul><li>Growth retardation </li></ul><ul><li>Facial malformations </li></ul><ul><li>Small head </li></ul><ul><li>Greatly reduced intelligence </li></ul>
  36. 42. Binge Drinking <ul><li>5 or more drinks in a sitting for men </li></ul><ul><li>4 or more drinks in a sitting for women </li></ul>
  37. 43. Dangers of Binge Drinking <ul><li>Unintentional injuries (e.g. car crash, falls, burns, drowning). </li></ul><ul><li>Intentional injuries (e.g. firearm injuries, sexual assault, domestic violence). </li></ul><ul><li>Alcohol poisoning. </li></ul><ul><li>STD’s and/or Unintended pregnancy. </li></ul><ul><li>High blood pressure, stroke, and other cardiovascular diseases. </li></ul><ul><li>Liver Disease </li></ul>
  38. 44. ALCOHOL TOXICITY <ul><li>A.MODERATE DRINKING </li></ul><ul><li>Nausea, vomiting </li></ul><ul><li>Flushing </li></ul><ul><li>Hangover </li></ul><ul><li>Traffic accidents </li></ul>
  39. 45. <ul><li>B. Acute alcoholic intoxication </li></ul><ul><li>Hypotension, gastritis, hypoglycemia, collapse, respiratory depression, coma & death </li></ul><ul><li>TREATMENT: </li></ul><ul><li>Patent airway </li></ul><ul><li>Tracheal intubation & positive pressure respiration </li></ul><ul><li>Fluid & electrolyte balance </li></ul><ul><li>Glucose infusion </li></ul>
  40. 46. <ul><li>Thiamine(100mg in 500ml glucose soln infused i.v. slowly) </li></ul><ul><li>Haemodialysis </li></ul><ul><li>Insulin + fructose drip </li></ul><ul><li>Gastric lavage </li></ul><ul><li>C. Chronic alcoholism </li></ul><ul><li>Tolerance & dependance develops & All systems affected. </li></ul>
  41. 47. WITHDRAWAL SYNDROME <ul><li>Anxiety, sweating,impairment of sleep, confusion, hallucinations, delirium, tremors,irritability,HTN, convulsions & collapse </li></ul><ul><li>Treatment </li></ul><ul><li>CNS depressants: barbiturates, phenothiazines, chloral hydrate </li></ul><ul><li>BENZODIAZEPINES & NALTREXONE </li></ul>
  43. 49. <ul><li>MANIFESTATIONS OF TOXICITY </li></ul><ul><li>Headache,vertigo,severe abdominal pain,vomiting,hypotension,delirium, acidosis & coma </li></ul><ul><li>Affinity for optic n  retinal damage  blindness(15ml) </li></ul><ul><li>Death(respiratory failure) </li></ul>
  44. 50. TREATMENT <ul><li>Correction of acidosis-IV sodium bicarbonate </li></ul><ul><li>Dark room </li></ul><ul><li>Gastric lavage </li></ul><ul><li>Maintain BP & ventilation </li></ul><ul><li>Ethyl alcohol </li></ul><ul><li>Antidote-FOMEPIZOLE </li></ul><ul><li>Haemodialysis </li></ul>
  45. 51. <ul><li>Drinking before age 21 is ILLEGAL!!! Don’t gamble with your future! </li></ul>
  46. 52. It Kills and Badly Injures
  48. 58. After a nasty break up she got drunk and went for a drive, with a BAC of .19, missed a turn, flipped and rolled the car more than 5 times. Fifteen surgeries later she is disfigured and blind with permanent brain damage, luckily she did not hurt or kill anyone else. Meet Denise Wagoner
  49. 60. DISULFIRAM <ul><li>Used in chronic alcoholics </li></ul><ul><li>Trade name: Antabuse & Antabus </li></ul>
  50. 61. <ul><li>ALCOHOL DH </li></ul><ul><li>ACETALDEHYDE DH </li></ul><ul><li>Disulfiram (-)acetaldehyde DH </li></ul>ALCOHOL ACETALDEHYDE ACETATE co 2 + H 2 O
  51. 62. <ul><li>4)Nausea & vomiting, </li></ul><ul><li>5)throbbing headache, visual disturbance, mental confusion, postural fainting, </li></ul><ul><li>6)circulatory collapse. </li></ul><ul><li>EFFECT:7-14 days after stopping alcohol </li></ul><ul><li>Aversion to alcohol intake-gives up the habit. </li></ul>
  52. 64. <ul><li>Peak-12hrsDosage:1g,0.75g,0.5g,0.25g </li></ul><ul><li>sensitization:2-3hrs after 1 st dose </li></ul><ul><li>Disulfiram should not be taken if alcohol has been consumed in the last 12 hours </li></ul>
  53. 65. <ul><li>N o tolerance to disulfiram: longer it is taken, the stronger its effects. </li></ul><ul><li>As disulfiram is absorbed slowly through digestive tract and eliminated slowly by body, effects may last for up to 2 weeks after initial intake. </li></ul>
  54. 66. CONTRAINDICATIONS <ul><li>Liver disease </li></ul><ul><li>Physically dependant on alcohol </li></ul><ul><li>SIDE EFFECTS </li></ul><ul><li>rashes, metallic taste, nervousness, malaise, abdominal upset, tingling of legs & shortness of breath </li></ul>
  55. 67. DRUGS THAT PPT DISULFIRAM LIKE REACTIONS <ul><li>Metronidazole </li></ul><ul><li>Sulfonylureas </li></ul><ul><li>Griseofulvin </li></ul><ul><li>Some cephalosporins </li></ul><ul><li>Phenylbutazone </li></ul><ul><li>Nitrofurantoin </li></ul>
  56. 68. Don’t Live Dangerously
  57. 69. Too Smart To Start
  58. 70. SAFEST AMOUNT OF DRINKS = 0!!! This is at any age!!!!
  59. 71. THANK YOU