II. Physiology

  1. Central Nervous System Depressant and Sedative via GABA-mediated activation

III. Adverse Effects: Acute Effects in Children (acute Poisoning)

IV. Adverse Effects: Adults

V. Drug Interactions: Disulfiram Reaction Risk (Antabuse Reaction Risk)

  1. Chlorpropamide
  2. Antibiotics
    1. Metronidazole
    2. Tinidazole
    3. Cefoperazone
    4. Cefotetan

VI. 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)

VII. 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)

VIII. 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

IX. Benefits: 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

X. References

  1. (2015) Presc Lett 22(12): 70
  2. (2008) Presc Lett 15(1):3

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Related Studies

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
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ドクサヨウ
French Effet toxique de l'alcool éthylique
Italian Effetti tossici dell'alcool etilico
Czech Toxický účinek etanolu
Korean 에탄올의 중독작용
Hungarian Etilalkohol toxikus hatása