Alcohol

Indications
 Oral
Antidote for methanol or ethylene glycol ingestion
Adult: Using 98% solution: Initial: 600-700 mg/kg. Maintenance dose: Non-drinker: 66 mg/kg/hr. Chronic drinker: 154 mg/kg/hr. Solution must be diluted to a ≤20% concentration with water or juice before admin. Continue until methanol or ethylene glycol is no longer detected or <20 mg/dL and metabolic acidosis is corrected and patient is asymptomatic. May also be given via IV admin.
Contraindications
 Epilepsy; urinary tract infection; alcoholism; diabetic coma.
Warnings / Precautions
 Women, elderly; peptic ulcer; renal function impairment; excessive alcohol intake particularly in diabetic and epileptic patients; porphyria. Chronic alcoholics may have tolerance to other CNS depressants including general anaesthetics. Take caution when driving of any type of transport or operating machines. Shock, cranial, following cranial surgery and in actual or expected postpartum haemorrhage; vit deficiency; IV admin results in dilution of serum electrolyte concentrations, overhydration, congestion or pulmonary oedema; extravasation during IV administration; haemolysis or pseudoagglutination; gout. Monitor electrolyte conc changes and fluid and acid-base balance. Pregnancy; lactation.
Adverse Reactions
 loss of judgement, emotional lability, visual impairment, slurred speech, ataxia (low to moderate concentrations); hangover effects eg, nausea, headache, dizziness, tremor; lethargy, amnesia, hypothermia, hypoglycaemia (particularly in children), stupor, coma, resp depression, cardiomyopathy, hypertension, CV collapse; damage to brain and liver which may lead to Wernike-Korsakoff syndrome (chronic excessive alcohol consumption); fat deposits in the liver, reduction in blood cell counts; pancreatitis, increased risk of CV disease (high alcohol consumption); ischemic heart disease but at a lower risk (moderate alcohol consumption); increased risk to some types of cancer.
Drug Interactions
 Acute alcohol intake inhibits drug metabolism of drug while chronic alcohol ingestion enhances the induction of hepatic drug metabolising enzymes. Alcoholic beverages containing tyramine when taken with MAOIs may cause reactions. Enhances acute CNS depression effects of drugs eg, hypnotics, antihistamines, antidepressants, antipsychotics and sedatives. Disulfiram-lilke reactions may manifest when taken concomitantly with chlorpropamide, mepacrine, metronidazole and other nitroimidazoles, furazolidone, nifuratel, procarbazine, cephalosphorins. Diabetic patients under sulfonylurea antidiabetics or insulin may experience orthostatic hypotension if taken with vasodilators. Enhances hypotensive effects of antihypertensive agents. Increases sedative effect of indoramin and gastric bleeding by analgesics. Decreases antidiuretic effects of vasopressin.
See Below for More alcohol Drug Interactions
Mechanism of Actions
 Ethanol stimulates GABA at GABA-A receptors and inhibits the opening of NMDA receptor/channels by preventing glutamate. As an antidote, it inhibits the rapid metabolism of methanol to toxic intermediates eg, formaldehyde and formic acid due to its greater affinity to alcohol dehydrogenase. Thus, the toxicity of methanol is delayed or to an extent hindered. The remaining methanol will proceed to its rate-limiting pathway of forming nontoxic metabolite lactate.
Absorption: Rapidly absorbed from the GI tract affected by several factors eg, presence of food, alcohol concentration, and time of ingestion; via lungs.
Distribution: Body fluids; crosses the placenta
Metabolism: Hepatic, conversion to acetaldehyde by alcohol dehydrogenase and oxidation to acetate occur at a rate approx 10-20 mL/hr; sedative effects of alcohol manifest when infusion rate is > metabolism rate. Via gastric mucosal; involves hepatic microsomal system; 90-98% of alcohol undergoes oxidation. Increased rate may be influenced by repeated excessive alcohol intake and by several substances like insulin. Decreased metabolism rate during starvation state.
Excretion: Via kidneys (unchanged form); via lungs; small amounts in breast milk, sweat and other secretions.
Available As
  • Alcohol 0.004 ml
  • Alcohol 0.15 mg
  • Alcohol 0.15 ml
  • Alcohol 0.25 ml
  • Alcohol 0.26 ml
  • Alcohol 0.2625 ml
  • Alcohol 0.32 ml
  • Alcohol 0.35 ml
  • Alcohol 0.5 ml
  • Alcohol 0.5% v/v
  • Alcohol 0.525 ml
  • Alcohol 0.525%
  • Alcohol 0.53 ml
  • Alcohol 0.55 ml
  • Alcohol 0.87 ml
  • Alcohol 0.95 ml
  • Alcohol 1%
  • Alcohol 1% v/v
  • Alcohol 1% w/w
  • Alcohol 1.425 ml
  • Alcohol 1.58 ml
  • Alcohol 1.65 ml
  • Alcohol 1.75 ml
  • Alcohol 1.8%
  • Alcohol 10% v/v
  • Alcohol 13.1 v/v
  • Alcohol 13.1% v/v
  • Alcohol 15 ml
  • Alcohol 2% v/v
  • Alcohol 2.08 ml
  • Alcohol 2.2 ml
  • Alcohol 2.37% v/v
  • Alcohol 3 mg
  • Alcohol 3%
  • Alcohol 3.4%
  • Alcohol 3.8% v/v
  • Alcohol 36.8% v/v
  • Alcohol 45%-48% v/v
  • Alcohol 45-48% v/v
  • Alcohol 48% v/v
  • Alcohol 49.7% v/v
  • Alcohol 5 mg
  • Alcohol 5%
  • Alcohol 5% v/v
  • Alcohol 50% v/v
  • Alcohol 60% w/w
  • Alcohol 60.80% w/v
  • Alcohol 61% v/v
  • Alcohol 63%
  • Alcohol 7.5% v/v
  • Alcohol 7.5% w/v
  • Alcohol 91.5% w/w

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