ETHYL ALCOHOL

Topics to be discussed

• Pharmacokinetics• Interactions• Contraindications• Guidelines for safe drinking

PHARMACOKINETICS

ABSORPTION

• In stomach –quite slow• In intestine- very fast

• From skin – minimal in adults• Significant in infants given

alcoholic sponges

• Distributed widely in body• Crosses BBB & placenta

efficiently• Concentration in brain near to

blood

Ethyl alcohol

• Alcohol dehydrogenase

Acetaldehyde

• Aldehyde dehydrogenase

A small amount of alcohol is oxidized by hepatic microsomal enzymes mainly CYP2E1

Metabolism of alcohol is zero order kinetics.

EXCRETION

In exhaled air 0.05% of blood concentration

• Medico legal determination of drunken state

Through kidney and lungs

• Neither is quantitatively significant

INTERACTIONS

AnxiolyticsAntidepressantsAntihistaminics

HypnoticsOpioids

• Marked cns depression with motor impairment

Sulfonyl ureaCefoperazoneMetronidazole

• Experience bizarre, somewhat disulfiram like reactions

InsulinSulfonyl urea • Enhances hypoglycemic action

AspirinOther NSAID`S • Increases gastric bleeding

CYP Enzymes(especially CYP2E1)

• Acute alcohol intake-inhibits• Chronic alcohol intake-induces• Toxic metabolites of

paracetamol increased

Other drugs like tolbutamide,

phenytoin• Metabolism of these drugs are

affected

FOOD VALUE

• Alcohol requires no digestion &metabolised rapidly

• It is an energy yielding substrate,7cal/g• Spares carbohydrates and fats as energy source• Regular intake can contribute to obesity• Alcohol does not supply body buildings & other

essential constituents of food• It cause nutritional deficiencies

CONTRAINDICATIONS

• Intake of alcohol should be avoided by

Peptic ulcer,hyperacidity& gastroeosophageal reflux patients

Epileptics

Unstable personalities

Severe liver patientsPregnant women produce foetal

alcoholic syndrome

Foetal alcohol syndrome• Results in

Intrauterine & postnatal growth restrictionLow IQMicrocephalyCraniofacial &other abnormalities Increased susceptibility to infections

• Heavy drinking during pregnancy increases incidence of miscarriage, still birth & low birth weight babies

Guidelines for safe drinking

• On an average 1-2 drinks per day is usually safe• Not more than 3 drinks on any occasion• Do not drive or engage in hazardous activities after

drinking• Do not drink if an interacting drug has been taken• Subjects with any contraindication should not drink• Safer limit for women is lower than men since

metabolism is slower & bioavailability high in women