Overview Function elimate ethanol (EtOH) CNS depressant/toxin Kinetics NAD+ is limiting reagent alcohol dehydrogenase operates via zero-order kinetics inhibitors fomepizole inhibits alcohol dehydrogenase antidote for suspected ethylene glycol or methanol poisoning disulfiram (Antabuse) inhibits acetaldehyde dehydrogenase acetaldehyde accumulates leads to hangover symptoms prescribed to help recovering alcoholics Clinical relevance ethanol hypoglycemia pathophysiology ↑ in EtOH metabolism → ↑ NADH/NAD+ ratio NADH/NAD+ ratio changes energy generating kinetics lactate favored over pyruvate lactate + NAD+ → pyruvate + NADH no free NAD+ for required conversion glycerol-3-phosphate favored over DHAP G3P + NAD+ → DHAP + NADH malate favored over oxaloacetate malate + NAD+ → OAA + NADH presentation lactic acidosis ↑ lactate fatty liver ↑ G3P results in ↑ synthesis of TGs ethanol + extreme physical exertion severe hypoglycemia EtOH inhibits the Cori cycle by consumption of free NAD+ conversion of lactate to glucose in anaerobic metabolism lactic acidosis
QUESTIONS 1 of 2 1 2 Previous Next Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK (M1.BC.14.1) An 18-year-old male presents to the emergency room smelling quite heavily of alcohol and is unconscious. A blood test reveals severe hypoglycemic and ketoacidemia. A previous medical history states that he does not have diabetes. The metabolism of ethanol in this patient's hepatocytes resulted in an increase of the [NADH]/[NAD+] ratio. Which of the following reaction is favored under this condition? QID: 106289 Type & Select Correct Answer 1 Pyruvate to acetyl-CoA 13% (28/210) 2 Citrate to isocitrate 1% (3/210) 3 Oxaloacetate to malate 63% (132/210) 4 Oxaloacetate to phosphoenolpyruvate 19% (40/210) 5 Fumarate to malate 1% (3/210) M 1 Question Complexity E Question Importance Select Answer to see Preferred Response SUBMIT RESPONSE 3 Review Tested Concept Review Full Topic
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