Systemic Effects of Alcohol

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Systemic effects of alcohol

Alcohol comes under a category of drugs Used in therapeutics 1.Ablation therapy 2.Trigeminal neuralgia 3.Methanol poisoning Its potential to be the most abused drug has made it a topic for discussion Effects 1.Physical 2.Emotional 3.Social The physical effects of alcohol will be dealt with

Effect on nervous system 1.Black outs an episode of temporary anterograde amnesia, in which the person forgets all or part of what occurred during a drinking evening almost every person branded as an alcoholic has experienced atleast one such event . 2.Altered sleep pattern amount spent in REM sleep is reduced 3. Sleep apnea alcohol acts as a pharyngeal muscle relaxant common in elderly alcoholics

4.Hangover fatigue, headache, thirst and nausea 5.Peripheral neuropathy 5- 15 % of chronic alcoholics develop peripheral neuropathy predominantly small fibre neuropathy painful peripheral neuropathy distal and bilateral 6.Cerebellar degeneration Bilateral affects vermis gait disturbance and nystagmus 7.Cognitive impairement impaired judgement

8.Wernickes syndrome predominant thiamine deficiency ophthalmoparesis, ataxia, and encephalopathy individuals with transketolase deficiency are predisposed 9.Korsakoffs psychosis retrograde amnesia confabulation 10. Marchiafava-Bignami Disease corpus callosal degeneration progressive pyramidal tract signs, stupor and coma progressive dementia 11.Muscle atrophy proximal muscle involvement

12. Alcohol binge - rhabdomyolysis acute proximal muscle weakness CPK increased 50 fold myoglobinuria and renal failure 13.Subdural hematoma increased frequency of trivial fall can present with cognition abnormality, hemiparesis,gait disturbances

Effects on GIT and hepatobiliary system Esophagus and stomach GERD, Mallory Weiss tear, hemorrhaghic gastritis Oral and esophageal cancer 2 times more common than in non alcoholics Pancreatitis Acute and chronic pancretitis usually acalculous hemorrhaghic pancreatitis common duration of alcohol does not matter much common during acute binge drinking

Liver alcoholic liver disease 1.Fatty liver 2.Alcoholic hepatitis 3.Cirrhosis Fatty liver stage of reversibility Alcoholic hepatitis Inflammation of liver cells Mallory bodies Balloning degenaration of cells Patient presents with jaundice, fatiguability,bleeding tendency, tender hepatomegaly Reversible Abstinence is the best treatment Other supportive management

Cirrhosis 15% of chronic alcoholics micronodular and macronodular cirrhosis all features of decompensated liver disease Asscoiation with Hepatitis C virus common This dreaded association has increased tendency to develop Hepatocellular carcinoma(HCC) Rectal carcinoma Incidence is increased two fold

Effects on cardiovascular system 1.Cardiomyopathy a form of dilated cardiomyopathy systolic dysfunction 2.Holiday heart syndrome sudden cardiac death due to arrythmia due to alcohol binge 3.Coronary heart disease six fold increase in chronic heavy drinkers 30 40 % increase in cardiovascular mortality

Effects on genitourinary system MEN Modest ethanol doses increase sexual drive Decrease erectile capacity Irreversible testicular atrophy shrinkage of the seminiferous tubules, decreases in ejaculate volume lower sperm count WOMEN amenorrhea decrease in ovarian size absence of corpora lutea with associated infertility increased risk of spontaneous abortion.

Effects on Hematopoietic system Increase in red blood cell size MCV folic acid deficiency hypersegmented neutrophils, reticulocytopenia, hyperplastic bone marrow Decrease production of white blood cells, decrease granulocyte mobility and adherence, impair delayed-hypersensitivity Mild thrombocytopenia

Effects on hormones increase in cortisol levels, inhibition of vasopressin secretion reversible decrease in serum thyroxine (T4) decrease in serum triiodothyronine (T3). Most hormone abnormalities are corrected with abstinence Reduces bone density

Fetal Alcohol Syndrome Heavy drinking during pregnancy results in rapid placental transfer of both ethanol and acetaldehyde serious consequences for fetal development. Any amount of alcohol can be hazardous No trimester relation observed Best way to prevent is ABSTINENCE

Fetal alcohol syndrome include : 1.A smooth philtrum The divot or groove between the nose and upper lip flattens with increased prenatal alcohol exposure. 2.Thin vermilion The upper lip thins with increased prenatal alcohol exposure. 3.Small palpebral fissures Eye width decreases with increased prenatal alcohol exposure

Fetal alcohol syndrome include : facial changes with epicanthal eye folds poorly formed ear concha small teeth with faulty enamel cardiac atrial or ventricular septal defects an aberrant palmar crease limitation in joint movement microcephaly with mental retardation The main effect of FAS is permanent central nervous system damage, especially to the brain.

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