II. Physiology
- Central Nervous System Depressant and Sedative via GABA-mediated activation
- Metabolism
- Alcohol undergoes hepatic metabolism in the liver by Alcohol dehydrogenase
- Alcohol elimination follows a dose dependent rate
III. Indications: Ethyl Alcohol Medical Uses
- Ethylene Glycol Poisoning
- Cardiovascular Prevention
- Excessive use has significant adverse effects
- Those who do not drink, should not start
- Alcohol's benefit is limited to low to moderate use
- Increases Cardioprotective Apolipoprotein A-1
- Decreases Atherogenic Apolipoprotein B
- Inhibits Platelet aggregation
- May result in Coronary Artery vasodilation
IV. Adverse Effects
- Ethanol in Children (Acute Poisoning)
- Ethanol in Adults
- Alcohol Abuse
- Alcoholic Hepatitis and Cirrhosis
- Korsakoff's Disease
- Fetal Alcohol Syndrome
- Alcohol Hangover
- Symptoms following a day of heavy drinking
- Toxic Alcohols
V. Precautions
- Powdered Alcohol (Palcohol)
- Approved by TTB in U.S., 2015 (but individual states may ban)
- Freeze-dried Alcohol in single serving sizes (one shot of liquor)
- Reconstituted with 6 ounces water
- Increased risk of abuse by teens
- (2015) Presc Lett 22(6): 34
VI. Drug Interactions: Disulfiram Reaction Risk (Antabuse Reaction Risk)
- Chlorpropamide
-
Antibiotics
- Metronidazole
- Tinidazole
- Cefoperazone
- Cefotetan
VII. Drug Interactions: Drug effect potentiated by Alcohol
-
Warfarin
- Increased INR with acute Alcohol use, decreased INR with chronic Alcohol use
- Sulfonylureas (Hypoglycemia)
- Avinza (Morphine Overdose due to rapid release)
- Extended-release agents (never use with Alcohol)
- CNS Depressants
VIII. Drug Interactions: Toxicity potentiated by Alcohol
- Hepatotoxicity risk
- Heavy Alcohol use potentiates hepatotoxicity (esp. >2 drinks per day)
- Isoniazid
- Acetaminophen
- Potentiated hepatotoxicity when Overdosed >4 grams/day
- Other effects
- NSAIDs or Aspirin (higher risk of Gastrointestinal Bleeding)
- Acitretin (converts to Teratogenic metabolites that take years to fully excrete)
- Chantix (increased aggressive behavior, Amnesia, Intoxication)
- Addyi or Flibanserin (severe Hypotension risk; no Alcohol within 2 days of Addyi use)
IX. Management
- See Alcohol Intoxication
- See Alcohol Dependence
- See Alcohol Withdrawal
- See Alcohol Detoxification in Ambulatory Setting
- See Alcoholism Management
- Alcohol Hangover
- Alcohol additives (e.g. Sulfites, tannins and other congeners) may increase hangover risk
- Hangover risk is most correlates with Alcohol amount (not the type or order of intake)
- Eye opener Alcohol use simply postpones the hangover
- Increased hydration is often needed, but does not reduce the hangover effects
- Oral Analgesics may be helpful
- No Vitamin, herbal or supplement has been found effective for hangovers
- (2025) Presc Lett 32(2): 10
- Roberts (2022) Addiction 117(8):2157-67 +PMID: 34972259 [PubMed]
X. References
- (2015) Presc Lett 22(12): 70
- (2008) Presc Lett 15(1):3
Images: Related links to external sites (from Bing)
Related Studies
| alcohol (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| ALCOHOL 70% PREP PADS | Generic OTC | $0.01 each |
Ontology: alcohol use disorder (C0001956)
| Concepts | Mental or Behavioral Dysfunction (T048) |
| English | Alcohol Use Disorders, alcohol use disorders, alcohol use disorder |
Ontology: Ethanol (C0001962)
| Definition (MEDLINEPLUS) |
If you are like many Americans, you drink alcohol at least occasionally. For many people, moderate drinking is probably safe. It may even have health benefits, including reducing your risk of certain heart problems. Moderate drinking is one drink a day for women or anyone over 65, and two drinks a day for men under 65. Some people should not drink at all, including alcoholics, children, pregnant women, people on certain medicines and people with some medical conditions. If you have questions about whether it is safe for you to drink, speak with your healthcare provider. Anything more than moderate drinking can be risky. Binge drinking - drinking five or more drinks at one time - can damage your health and increase your risk for accidents, injuries and assault. Years of heavy drinking can lead to liver disease, heart disease, cancer and pancreatitis. It can also cause problems at home, at work and with friends. NIH: National Institute on Alcohol Abuse and Alcoholism |
| Definition (NCI) | A volatile liquid prepared by fermentation of certain carbohydrates. Alcohol acts as a central nervous system (CNS) depressant, a diuretic, and a disinfectant. Although the exact mechanism of CNS depression is unknown, alcohol may act by inhibiting the opening of calcium channels, mediated by the binding of the inhibitory neurotransmitter gamma-amino butyric acid (GABA) to GABA-A receptors, or through inhibitory actions at N-methyl-D-aspartate (NMDA)-type glutamate receptors. Alcohol inhibits the production of antidiuretic hormone, thereby producing diuresis that may lead to dehydration. This agent kills organisms by denaturing their proteins. |
| Definition (NCI_NCI-GLOSS) | A chemical substance found in beer, wine, and liquor, and some medicines, mouthwashes, household products, and essential oils (scented liquid taken from plants). Alcohol contains a carbon atom attached to a hydroxyl group (a molecule made of an oxygen atom and a hydrogen atom). |
| Definition (MSH) | A clear, colorless liquid rapidly absorbed from the gastrointestinal tract and distributed throughout the body. It has bactericidal activity and is used often as a topical disinfectant. It is widely used as a solvent and preservative in pharmaceutical preparations as well as serving as the primary ingredient in ALCOHOLIC BEVERAGES. |
| Definition (CSP) | two carbon primary alcohol formed by microbial fermentation of carbohydrates or by synthesis from ethylene; it is a clear, colorless liquid rapidly absorbed from the gastrointestinal tract and distributed throughout the body; it has bactericidal activity and is used often as a topical disinfectant; it is widely used as a solvent and preservative in pharmaceutical preparations as well as serving as the active ingredient in alcoholic beverages. |
| Definition (PDQ) | A colorless organic liquid also known as ethyl alcohol or grain alcohol. Ethanol's primary physiologic effects involve the central nervous system. Depending on the dose delivered, ethanol behaves as an anxiolytic, a depressant, or a general anesthetic. Ethanol-induced immunosuppression involves dysregulation of CD4+ T cells. Check for "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=446576&idtype=1" active clinical trials or "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=446576&idtype=1&closed=1" closed clinical trials using this agent. ("http://nciterms.nci.nih.gov:80/NCIBrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&code=C216" NCI Thesaurus) |
| Concepts | Organic Chemical (T109) |
| MSH | D000431 |
| SnomedCT | 398624005, 32055008, 419442005 |
| LNC | LP20735-4, LP14348-4, MTHU001345 |
| English | Alcohol, Ethyl, Ethanol, Ethyl Alcohol, Alcohol, Grain, ETOH, Grain Alcohol, Alcohol, alcohol, Absolute Ethanol, Methylcarbinol, ethanol (medication), Ethanol [Chemical/Ingredient], ALCOHOL, alcohol ethyl, grain alcohol, EtOH, ethanols, ethanol, ETHANOL, ethyl alcohol, Grain alcohol, Drinking alcohol, Absolute ethanol, Ethyl alcohol, Ethyl alcohol (product), Alcohol (Grain), ALCOHOL,ETHYL, EtOH - Ethanol, EtOH - Alcohol, Ethyl alcohol (substance) |
| Spanish | alcohol etílico (sustancia), etanol, alcohol para beber, alcohol de grano, alcohol etílico (producto), alcohol etílico, Etanol, Alcohol Etílico |
| Swedish | Etanol |
| Czech | ethylalkohol, tribromethanol, ethanol, etanol, líh |
| Finnish | Etanoli |
| French | Esprit de vin, Méthylcarbinol, Alcool éthylique, Éthanol |
| Italian | Alcol etilico, Alcol di grano, Etanolo |
| Russian | ETANOL, SPIRT ETILOVYI, СПИРТ ЭТИЛОВЫЙ, ЭТАНОЛ |
| Croatian | ETANOL |
| Polish | Etanol, Alkohol etylowy |
| Japanese | アルコール-エチル, エタノール, エチルアルコール, 酒精 |
| Norwegian | Etanol |
| Portuguese | Etil Álcool, Etanol, Álcool Etílico |
| German | Alkohol, Ethyl-, Ethanol, Ethylalkohol, Alkohol, Äthyl-, Äthanol, Äthylalkohol |
Ontology: Toxic effect of ethyl alcohol (C0161679)
| Concepts | Injury or Poisoning (T037) |
| ICD9 | 980.0 |
| ICD10 | T51.0 , T51.0X1, T51.0X |
| SnomedCT | 212808007, 157684002, 212806006, 82782008 |
| English | Ethanol, Toxic effect of ethyl alcohol, Ethyl alcohl causng tox effect, Ethyl alcohol causing toxic effect, Ethyl alcohol causing toxic effect NOS, Ethyl alcohol-toxic effect NOS, Toxic eff ethyl alcohol, Toxic effect of ethanol NOS, Ethyl alcohol causing toxic effect NOS (disorder), Ethyl alcohol causing toxic effect (disorder), Ethanol intoxication, Toxic effect of ethanol, Toxic effect of grain alcohol, Ethanol causing toxic effect, Toxic effect of ethyl alcohol (disorder) |
| Dutch | toxisch gevolg van ethylalcohol, Ethanol |
| German | toxischer Effekt von Aethylalkohol, Toxische Wirkung: Aethanol |
| Portuguese | Efeito tóxico de álcool etílico |
| Spanish | Efecto tóxico del alcohol etílico, alcohol etílico que causa efectos tóxicos, alcohol etílico que produce efecto tóxico, SAI, alcohol etílico que causa efectos tóxicos (trastorno), alcohol etílico que produce efecto tóxico, SAI (trastorno), efecto tóxico del alcohol etílico (trastorno), efecto tóxico del alcohol etílico, efecto tóxico del etanol |
| Japanese | エチルアルコールの毒作用, ｴﾁﾙｱﾙｺｰﾙﾉﾄﾞｸｻﾖｳ |
| French | Effet toxique de l'alcool éthylique |
| Italian | Effetti tossici dell'alcool etilico |
| Czech | Toxický účinek etanolu |
| Korean | 에탄올의 중독작용 |
| Hungarian | Etilalkohol toxikus hatása |
Ontology: Hangover from alcohol (C0393756)
| Concepts | Sign or Symptom (T184) |
| SnomedCT | 191880005, 32553006 |
| English | Hangover from alcohol, hangover (alcohol), Alcoholic hangover, Hangover alcoholic, hangover, alcohol hangover, hangovers, hangover effect, Hangover (alcohol), Hangover, Hangover effect, Hangover (finding), Hangover, alcohol |
| Italian | Postumi alcoolici, Postumi da alcool |
| Dutch | kater door alcohol, alcoholkater |
| French | Obnubilation d'origine alcoolique, Gueule de bois d'origine alcoolique |
| German | Kater alkoholbedingt, alkoholbedingter Kater |
| Japanese | アルコールによる宿酔, ｱﾙｺｰﾙﾆﾖﾙｼｭｸｽｲ |
| Czech | Kocovina po alkoholu |
| Hungarian | Alkoholos másnaposság |
| Spanish | efectos de la resaca, resaca (hallazgo), resaca, Resaca alcohólica |
| Portuguese | Ressaca alcoólica |
