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  1. #1
    Asclepius1's Avatar
    Asclepius1 is offline Ultimate Member 537 points
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    Alcohol and thiamine

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    In an alcoholic why do you have to give thiamine before you give glucose? Please explain in detail.

  2. #2
    usmle2007 is offline Newbie
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  3. #3
    thalamus is offline Newbie
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    well . . . when u receive ur alcoholic patient who probably have an hypoglicemic state, certanly u have to administrate glucose, this glucose is metabolized to pyruvate in glycolisis and after that is converted to acetyl-coA to enter to krebs cycle. To convert pyruvate in acetyl-coA you need the enzyme PDH (pyruvate dehydrogenase), this enzyme require thiamine as cofactor. If you dont administer thiamine pyruvate cant be metabolized to acetyl-coA. Pyruvate instead is metabolized to lactate, thus your patient will die from an lactic acidosis.

    i hope this will answer your question.

  4. #4
    Asclepius1's Avatar
    Asclepius1 is offline Ultimate Member 537 points
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    This is a very good explanation. However, there is also another explanation. If you don't have thiamine, you cells can't reuptake glucose and you have hypgerglycemic state.

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