Systemic effects of alcohol

?lcohol comes under a category of drugs

Used in therapeutics
1.? lation therapy
2.Trigeminal neuralgia
3.Methanol poisoning

Its potential to e the most a used drug has made it a topic for
discussion

Effects
1.Physical
2.Emotional
3.Social

The physical effects of alcohol will e dealt with

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an episode of temporary anterograde amnesia, in which the

person forgets all or part of what occurred during a drinking evening
almost every person randed as an alcoholic has experienced atleast
one such event͙͙͙.








amount spent in REM sleep is reduced





alcohol acts as a pharyngeal muscle relaxant
common in elderly alcoholics
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fatigue, headache, thirst and nausea





5- 15 % of chronic alcoholics develop peripheral neuropathy
predominantly small fi re neuropathy
painful peripheral neuropathy
distal and ilateral


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Bilateral
affects vermis
gait distur ance and nystagmus
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impaired judgement
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predominant thiamine deficiency
ophthalmoparesis, ataxia, and encephalopathy
individuals with transketolase deficiency are predisposed

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retrograde amnesia
confa ulation
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corpus callosal degeneration
progressive pyramidal tract signs, stupor and coma
progressive dementia
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acute proximal muscle weakness

CPK increased 50 fold
myoglo inuria and renal failure

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increased frequency of trivial fall
can present with cognition a normality, hemiparesis,gait
distur ances
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ÄERD, Mallory Weiss tear, hemorrhaghic gastritis


 



2 times more common than in non alcoholics



?cute and chronic pancretitis
usually acalculous
hemorrhaghic pancreatitis common
duration of alcohol does not matter much
common during acute inge drinking
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1.Fatty liver
2.?lcoholic hepatitis
3.Cirrhosis
Fatty liver ʹ stage of reversi ility

?lcoholic hepatitis
Inflammation of liver cells
Mallory odies
Balloning degenaration of cells

Patient presents with

jaundice, fatigua ility, leeding tendency, tender hepatomegaly
Reversi le
? stinence is the est treatment
Other supportive management
 


15% of chronic alcoholics

micronodular and macronodular cirrhosis
all features of decompensated liver disease
?sscoiation with Hepatitis C virus common
This dreaded association has increased tendency to develop
Hepatocellular carcinoma(HCC)

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Incidence is increased two fold
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a form of dilated cardiomyopathy
systolic dysfunction





sudden cardiac death due to arrythmia due to alcohol inge

 





six fold increase in chronic heavy drinkers

30 ʹ 40 % increase in cardiovascular mortality

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Modest ethanol doses increase sexual drive
Decrease erectile capacity
Irreversi le testicular atrophy
shrinkage of the seminiferous tu ules,
decreases in ejaculate volume
lower sperm count

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amenorrhea
decrease in ovarian size
a sence of corpora lutea with associated infertility
increased risk of spontaneous a ortion.
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Increase in red lood cell size MCV
folic acid deficiency
hypersegmented neutrophils,
reticulocytopenia,
hyperplastic one marrow

Decrease production of white lood cells,

decrease granulocyte mo ility and adherence,
impair delayed-hypersensitivity

Mild throm ocytopenia

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increase in cortisol levels,

inhi ition of vasopressin secretion
reversi le decrease in serum thyroxine (T4)
decrease in serum triiodothyronine (T3).

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Heavy drinking during pregnancy results in

rapid placental transfer of oth ethanol and acetaldehyde
serious consequences for fetal development.
?ny amount of alcohol can e hazardous
No trimester relation o served
Best way to prevent is ?

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include :

1.? smooth philtrum Ͷ The divot or groove etween the nose and upper
lip flattens with increased prenatal alcohol exposure.
2.Thin vermilion Ͷ The upper lip thins with increased prenatal alcohol
exposure.
3.Small palpe ral fissures Ͷ Eye width decreases with increased prenatal
alcohol exposure
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include :
facial changes with epicanthal eye folds
poorly formed ear concha
small teeth with faulty enamel
cardiac atrial or ventricular septal defects
an a errant palmar crease
limitation in joint movement
microcephaly with mental retardation

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