Pharm

Alcohol

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Alcohol, Ethyl Alcohol, Ethanol, Alcohol-Related Drug Interactions, Toxic Effect of Alcohol, Alcohol Toxicity, Alcohol Related Cardiac Effects, Toxic Alcohol

  • See Also
  1. Alcohol Intoxication
  2. Alcohol Dependence
  3. Alcohol Withdrawal
  4. Alcohol Detoxification in Ambulatory Setting
  5. Alcoholism Management
  6. Chemical Dependency
  7. Drug Withdrawal
  • Physiology
  1. Central Nervous System Depressant and Sedative via GABA-mediated activation
  2. Metabolism
    1. Alcohol undergoes hepatic metabolism in the liver by Alcohol dehydrogenase
    2. Alcohol elimination follows a dose dependent rate
  • Adverse Effects
  1. Ethanol in Children (acute Poisoning)
    1. See Alcohol Poisoning
    2. Hypoglycemia
  2. Ethanol in Adults
    1. Alcohol Abuse
    2. Alcoholic Hepatitis and Cirrhosis
    3. Korsakoff's Disease
    4. Fetal Alcohol Syndrome
  3. Toxic Alcohols
    1. Methanol Poisoning
      1. Acute Vision Loss
      2. Parkinsonism
      3. Hemorrhagic Pancreatitis
      4. Death
    2. Ethylene Glycol Poisoning
      1. Renal Failure
    3. Isopropyl Alcohol Poisoning
      1. Rhabdomyolysis
      2. Shock
  1. Chlorpropamide
  2. Antibiotics
    1. Metronidazole
    2. Tinidazole
    3. Cefoperazone
    4. Cefotetan
  • Drug Interactions
  • Drug effect potentiated by Alcohol
  1. Warfarin
    1. Increased INR with acute Alcohol use, decreased INR with chronic Alcohol use
  2. Sulfonylureas (Hypoglycemia)
  3. Avinza (Morphine Overdose due to rapid release)
  4. Extended-release agents (never use with Alcohol)
    1. Nucynta ER
    2. Zohydro ER
    3. Opana ER
    4. Embeda
  5. CNS Depressants
    1. Benzodiazepines
    2. Opioids
    3. Benzodiazepine Receptor Agonist (e.g. Zolpidem or Ambien)
  • Drug Interactions
  • Toxicity potentiated by Alcohol
  1. Hepatotoxicity risk
    1. Heavy Alcohol use potentiates hepatotoxicity (esp. >2 drinks per day)
    2. Isoniazid
    3. Acetaminophen
      1. Potentiated hepatotoxicity when Overdosed >4 grams/day
  2. Other effects
    1. NSAIDs or Aspirin (higher risk of Gastrointestinal Bleeding)
    2. Acitretin (converts to Teratogenic metabolites that take years to fully excrete)
    3. Chantix (increased aggressive behavior, Amnesia, Intoxication)
    4. Addyi or Flibanserin (severe Hypotension risk; no Alcohol within 2 days of Addyi use)
  • Precautions
  1. Powdered Alcohol (Palcohol)
    1. Approved by TTB in U.S., 2015 (but individual states may ban)
    2. Freeze-dried Alcohol in single serving sizes (one shot of liquor)
    3. Reconstituted with 6 ounces water
    4. Increased risk of abuse by teens
    5. (2015) Presc Lett 22(6): 34
  • Indications
  • Ethyl Alcohol Medical Uses
  1. Ethylene Glycol Poisoning
  2. Cardiovascular Prevention
    1. Excessive use has significant adverse effects
    2. Those who do not drink, should not start
    3. Alcohol's benefit is limited to low to moderate use
      1. Increases Cardioprotective Apolipoprotein A-1
      2. Decreases Atherogenic Apolipoprotein B
      3. Inhibits Platelet aggregation
      4. May result in Coronary Artery vasodilation
  • References
  1. (2015) Presc Lett 22(12): 70
  2. (2008) Presc Lett 15(1):3