Why Alcoholics Should Receive Vitamin B1 (Thiamine) by IV ... | Alcohol thiamine

PleaseentertexttosearchSearchbyOutlineSetSearchLimitsAdvancedSearchBackHomeSearchbyOutlinesSetSearchLimitsSearchWithinAllKeyphrasesArticleTitleArticleContentTypeofSearchAlloftheWordsAnyoftheWordsExactPhraseLimittoaDatabaseAnatomyImagesBiostatisticsCalculatorsClinicalTrialsDifferentialDiagnosisDrugReferenceEBMTopicsLabTestsPharmacogeneticsPharmacologyPhysicalExamPracticeAreaProceduresRadiologyReferenceToolsToxicology(OR)SearchDatabasesManuallybyOutlineAnatomyImagesBiostatisticsCalculatorsClinicalTrialsDifferentialDiagnosisDrugReferenceEBMTopicsLabTestsPharmacogeneticsPharmacologyPhysicalExamPracticeAreaProceduresRadiologyReferenceToolsToxicologyWhyAlcoholicsShouldReceiveVitaminB1(Thiamine)byIVBeforeanyGlucoseInfusionsSummary:ItiswellknownthatchronicalcoholicsareathighriskforbeingdeficientinvitaminB1(thiamine),whichisknowntoputthepatientatanincreasedriskforWernicke-KorsakoffSyndrome,cerebellardegeneration,andcardiovasculardysfunction.Thecurrentstandardoftreatmentforsuchpatientsistogivethemthiamine100mgintravenously(IV)beforeadministeringglucosecontainingIVfluidsandthentocontinuethisdoseforseveraldays.TheinabilityofpyruvatetoentertheTCAcyclecausesthecelltoconvertthepyruvatetolactate(orlacticacid)inordertobeabletomaintainglycolysisataminimumrate. Therefore,ifyoufeedthecellmoreglucosewithoutgivingtheneededthiaminetoallowfortheforwardmovementofcellularreactionsforcompleteATPgeneration,youonlyincreasetheamountoflacticacidproduced.Thisdevelopmentofacidosis,theinabilityofthepentosephosphatepathwaytoprotectthecellfromreactiveoxygenspeciesthatdamagecellularstructuresandthemountingstressonthecelloverall,resultsineithercelldeathoractivationofapoptosis.Editor-in-Chief:AnthonyJ.Busti,MD,PharmD,FNLA,FAHAReviewers:JonD.Herrington,PharmD,BCPS,BCOPLastReviewed:October2015OtherEBMConsultRelatedContentPharmacology: WhyShouldAlcoholicsGetIVThiaminevsOralThiamineforReplacementPharmacology: Cellular&BiochemicalReactionsthatRequireVitaminB1orThiamineExplanationItiswellknownthatchronicalcoho

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