Pharm

Alcohol

search

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

  • 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
  • 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
  • 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
    5. Alcohol Hangover
      1. Symptoms following a day of heavy drinking
  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
  • 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
  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)
  • Management
  1. See Alcohol Intoxication
  2. See Alcohol Dependence
  3. See Alcohol Withdrawal
  4. See Alcohol Detoxification in Ambulatory Setting
  5. See Alcoholism Management
  6. Alcohol Hangover
    1. Alcohol additives (e.g. Sulfites, tannins and other congeners) may increase hangover risk
    2. Hangover risk is most correlates with Alcohol amount (not the type or order of intake)
    3. Eye opener Alcohol use simply postpones the hangover
    4. Increased hydration is often needed, but does not reduce the hangover effects
    5. Oral Analgesics may be helpful
    6. No Vitamin, herbal or supplement has been found effective for hangovers
    7. (2025) Presc Lett 32(2): 10
    8. Roberts (2022) Addiction 117(8):2157-67 +PMID: 34972259 [PubMed]
  • References
  1. (2015) Presc Lett 22(12): 70
  2. (2008) Presc Lett 15(1):3