Alcohol

The term "alcohol" has been synonymous with "spirituous" liquids for the past 300 years. The history of alcohol consumption, along with codes limiting its consumption go back to 1700 B.C. There are four types of alcohol: methyl alcohol, ethyl alcohol, propyl alcohol and butyl alcohol. Ethyl Alcohol, or ethanol (C 2 H 5 OH), is the type used in the production of alcoholic beverages. The other three types, methyl, propyl and butyl alcohol, if consumed can result in blindness and death, even in relatively small doses. Alcohol, or ethanol, is the intoxicating agent found in beer, wine and liquor. Alcohol is produced by fermentation of yeast, sugars, and starches. 1 Fruits such as grapes, and grains like barley and wheat are most commonly used for wine, beer and liquors. Other plants, such as the cactus or sugar cane may be used in liquor production. Fourteen grams or about 0.6 fluid ounces of pure alcohol equals one “drink”. Examples of this amount may include one twelve ounce beer (5 percent alcohol), eight to nine ounces of malt liquor (7 percent alcohol), 5 ounces of wine (12 percent alcohol) or 1.5 fluid ounce “shot” of 80 proof liquor (40 percent alcohol). In the U.S., The Federal Uniform Drinking Age Act, signed into law in 1984 raised the minimum drinking age to 21 years. All states now prohibit the purchase of alcohol by youth under the age of 21 years since 1988. It is illegal to sell or buy alcohol for anyone under the age of 21. According to The Office of the Surgeon General, alcohol is used by more young people in the United States than tobacco or illicit drugs, resulting in a serious public health concern. 2

The term "alcohol" has been synonymous with "spirituous" liquids for the past 300 years. The history of alcohol consumption, along with codes limiting its consumption go back to 1700 B.C. There are four types of alcohol: methyl alcohol, ethyl alcohol, propyl alcohol and butyl alcohol. Ethyl Alcohol, or ethanol (C 2 H 5 OH), is the type used in the production of alcoholic beverages. The other three types, methyl, propyl and butyl alcohol, if consumed can result in blindness and death, even in relatively small doses. Alcohol, or ethanol, is the intoxicating agent found in beer, wine and liquor. Alcohol is produced by fermentation of yeast, sugars, and starches. 1 Fruits such as grapes, and grains like barley and wheat are most commonly used for wine, beer and liquors. Other plants, such as the cactus or sugar cane may be used in liquor production. Fourteen grams or about 0.6 fluid ounces of pure alcohol equals one “drink”. Examples of this amount may include one twelve ounce beer (5 percent alcohol), eight to nine ounces of malt liquor (7 percent alcohol), 5 ounces of wine (12 percent alcohol) or 1.5 fluid ounce “shot” of 80 proof liquor (40 percent alcohol). In the U.S., The Federal Uniform Drinking Age Act, signed into law in 1984 raised the minimum drinking age to 21 years. All states now prohibit the purchase of alcohol by youth under the age of 21 years since 1988. It is illegal to sell or buy alcohol for anyone under the age of 21. According to The Office of the Surgeon General, alcohol is used by more young people in the United States than tobacco or illicit drugs, resulting in a serious public health concern. 2

Alcohol is contraindicated in conditions like Hepatic disease, Postpartum hemorrhage, Seizures, Renal impairment, Diabetic coma

The severe or irreversible adverse effects of Alcohol, which give rise to further complications include Coma, Cardiomyopathy. The signs and symptoms that are produced after the acute over dosage of Alcohol include Hypothermia, Metabolic acidosis, Hypoglycemia, CNS depression, Acute gastritis. The symptomatic adverse reactions produced by Alcohol are more or less tolerable and if they become severe, they can be treated symptomatically, these include Drowsiness, Ataxia, Lethargy, Slurred speech, Hypothermia, Dysarthria, Amnesia, Disinhibition.

Ethyl alcohol should be used with caution in patients with diabetes mellitus because ethanol can cause hypoglycemia, resulting in poor diabetic control. In untreated diabetics, the rate of ethanol metabolism is reduced. It should not be administered to patients in diabetic coma. Regular use should be avoided in patients with gout. Ethyl alcohol should be administered cautiously in patients with CNS depression. It should be avoided in patients who once suffered from alcoholism unless it is used in the treatment of alcohol withdrawal. Ethyl alcohol should not be used during pregnancy or lactation.

Drug should not be given to Paediatrics, Pregnant Mothers, Geriatrics, and Neonates.If prescribing authority justifies the benefits of the drug against the possible damages he/she should reevaluate them and consult the reference material and previous studies.

100 to 142.8 mg/kg.hr (120 (121.4)) As recommended. IV Inf — Maintenance, As Required 1000 mg/kg (1000 (1000)) As recommended. IV — Load for Once

Not Indicated in this Age Group ( ) —

Not indicated in this age group ( ) —

Alcohol is known to interact with other drugs, the details of drug interactions is as follows:DrugDetailsSeverityOnsetManagementAlprazolamAlcohol reduces the clearance of alprazolamAminoglutethimideAmisulprideIncreased sedative effects when antipsychotics (e.g Amisulpride) given with Alcohol.Amitriptyline (HCl)Amlodipine (Besylate)Enhanced hypotensive effect when calcium-channel blockers (e.g Amlodipine) given with Alcohol.AmoxapineIncreased sedative effect when amoxapine given with alcohol.MajorAspirinAzatadine (Maleate)BaclofenEnhanced sedative effects when Baclofen given with Alcohol.BendrofluazideBenorylateBenperidolIncreased risk of sedative effects when antipsychotics (e.g Benperidol) given with Alcohol. Benztropine (Mesylate)Increased sedative effects when Benztropine given with Alcohol.Betahistine (HCl)Bethanidine (Sulphate)Bovine InsulinBrimonidine (Tartrate)BromazepamBromocriptine (Mesylate)Tolerance of Bromocriptine reduced by Alcohol.Brompheniramine (Maleate)Buprenorphine (HCl)Buspirone (HCl)Butorphanol (Tartrate)CabergolineCaffeineCannabisCaptoprilEnhanced hypotensive effect when ACE inhibitors (e.g Captopril) given with Alcohol.CarbamazepineCNS-side effects of Carbamazepine possibly increased by Alcohol.Carbinoxamine (Maleate)Cefamandole (Na)CefazolinCefoperazoneCefotetanCeftriaxone (Na)Disulfiram like reaction occurs when ceftriaxone is used with alcohol.Cephazolin (Na)Cerivastatin SodiumCharcoal (Activated)Chloral BetaineChloral HydrateChlordiazepoxide (HCl)Chlormethiazole (Edisylate)ChlorothiazideChlorpheniramine (Maleate)MajorChlorpromazine (HCl)ChlorpropamideChlorprothixeneChlorthalidoneCholine Magnesium TrisalicylateChymotrypsinCilazaprilCitalopram (HBr)ClemastineClobazamClomipramine (HCl)ClonazepamClonidine (HCl)Clorazepate (K)Clotiazepamenhanced sedation effect.ClozapineCocaineCodeineCyanocobalaminCyclizineCyclopenthiazideCyproheptadine (HCl)Cyproterone (Acetate)DalteparinDanazolsubjective intolerance in the form of nausea and dyspnea may occurDantrolene (Na)Debrisoquine (Sulphate)Desipramine (HCl)Desmopressin (Acetate)Dexamphetamine (Sulphate)Dextromoramide (Tartrate)DextropropoxypheneDiamorphine (HCl)DiazepamAdditive CNS depressant activity. Ethanol increases Rate of GI absorption of DiazepamDiazoxideEnhanced hypotensive effect when Diazoxide given with Alcohol.Dihydrocodeine (Tartrate)DimenhydrinateDinoprostDiphenhydramineDiphenoxylate (HCl)Diphenyl PyralineDipipanone (HCl)DisulfiramDisulfiram inhibit enzyme aldehyde dehydrogenase responsible for oxidation of acetaldehyde to acetylCoA thusduring cosumption of alcohol flushing,nausea,blurred vision,hypotension and tachycardia may occur.MajorAlcohol should be avoided in patients receiving disulfiram.Dothiepin (HCl)Doxepin (HCl)Doxicycline HyclateDoxycyclineDroperidolDuloxetine HydrochlorideEnalapril (Maleate)EnfluraneEnoxaparinEphedrineErythromycinCoadministration delay absorption and clinical effects of erythromycin due to slowed gastric emptying by ethanol.MinorPatients should avoid alcohol when taking erythromycin.Estradiol (Valerate)Estrogens ConjugatedEthinamateConcurrent use may increase the CNS depressant effects of either of the medications.EthinyloestradiolEthionamideEthosuximideEtodolacFamotidineLevel of ethanol is increasedFenbufenFenoprofenFentanyl (Citrate)FloctafenineFlunarizine (HCl)Fluoxetine (HCl)Flupenthixol (HCl and Decanoate)FluphenazineFlurazepam (HCl)FlurbiprofenFructoseFurazolidoneCocurrent use lead to disulfiram-like reactionsi.e.flushing,lacrimation and sweating due to inhibition of enzyme by furazolidone results in accumulation of acetaldehyde.ModerateAvoid alcohol while taking furazolidone or within four days of stopping therapy.GlibenclamideGliclazideGlipizideGlyceryl TrinitrateGlymidineGriseofulvinGuanabenzGuanabenz acetate may intensify effect of alcohol.GuanethidineHalazepamHaloperidolHalothaneHeparin (Na) and Heparin (Cl)Hexobarbitone (Na)Human InsulinHydralazine (HCl)HydrochlorothiazideHydroflumethiazideHydromorphoneHydroxyureaHydroxyzineHyoscine (Butylbromide)Imipramine (HCl)IndomethacinIndoramin (HCl)Sedative effect of indoramin enhanced.Insulin GlulisineInsulin LisproIron SaltsIsocarboxazidIsoetharineIsoniazidAlcoholic patients show high INH-induced hepatotoxicity.ModerateCoadministration is considered as contraindicated and clinicians should aware of risk of hepatotoxicity.IsoniazidIsophane insulinIsosorbide (Dinitrate)Isosorbide 5-MononitrateKetamine (HCl)KetazolamKetoconazoleCoadministration results in disulfiram-like reactions(swaeting,nausea,flushing,headache)MinorWhile taking ketoconazole patient advised to minimize alcohol consumption.Ketotifen (Fumarate)Latamoxef (Na)Lercanidipine (HCl)LevodropropizineLevorphanolLevorphanolConcurrent use with Alcohol may result in additive CNS depression.LevosulpirideLisinoprilLithiumCoadministration result in additive central nervous system and impairment, thinking and psychomotor skills.ModeratePatient should be warned of interaction and advised to limit alcohol cosumption.Lofepramine (HCl)LofexidineLofexidine may increase central depressant effect of sedative agents including alcohol.LomustineLomustine is soluble in alcohol. Some sources recommend avoidance of alcohol on days that lomustine is administered to avoid possible effects on the absorption of lomustine, although there is no documentation of an interaction.LorazepamLormetazepamLynoestrenolLypressinMaprotiline (HCl)Coadministration result in additive central nervous system and impairment, thinking and psychomotor skills.ModeratePatient should be warned of interaction and advised to limit alcohol cosumption.MebhydrolinMecamylamineThe action of Mecamylamine may be potentiated by alcohol.MeclizineMeclofenamic AcidMeclozineMedazepamMedroxyprogesterone (Acetate)MeloxicamMentholMepacrine (HCl)MeprobamateMepyramineMequitazineMestranolMetaxaloneMetformin (HCl)Ethanol initiate effects of metformin on lactate metabolism.ModerateAvoid intake of alcohol and notify the signs of lactic acidosis like malaise,respiratory distress,somnolence and irregular heart beat.MethadoneMethocarbamolMethocarbamol may possess a general CNS depressant effect, patients receiving Methocarbamol Injectable should be cautioned about combined effects with alcohol and other CNS depressants.MethotrexateMethotrimeprazine (Maleate)MethyclothiazideMethypryloneMetronidazoleMetyrosineMetyrosine may add to the sedative effects of alcohol and other CNS depressants, e.g., hypnotics, sedatives, and tranquilizers.MianserinMidazolamMirtazapineMolindonethe sedative effect is increased when taken with Molindone.MorphineNalbuphine (HCl)Naloxone (HCl)Nicotinic AcidNifuroxazideIntake of alcohol or alcohol preparations during treatment of Nifuroxazide causes feeling of heat in face and neck, heaviness in occipital part of head, tachycardia and reduction of blood pressure.NifurtimoxNimetazepamNitrazepamNitroglycerinAlcohol may intensify the blood pressure lowering effect of nitroglycerin and result in collapsePatients receiving nitroglycerin should be advised to drink alcoholic beverages with caution.Nortriptyline (HCl)NylidrinConcurrent use may increase the risk of dizziness.OlanzapineOrciprenaline (Sulphate)OrphenadrineOxaprozinOxatomideOxazepamOxygenPapaveretumParacetamolParoxetinePentazocinePentobarbitone (Na)Peppermint OilPerindoprilPerphenazinePethidine (HCl)PhenindionePhenobarbital SodiumAlcohol enhances effects of phenobarbital sodium.PhenobarbitonePhentermineConcomitant use of alcohol with phentermine hydrochloride may result in an adverse drug interaction.Phenylbutazone Phenytoin (Na)Pholcodine PimozidePinacidil MonohydratePinazepamPipothiazinePizotifen (Hydrogen Maleate)PolythiazidePorcine InsulinPrazepamPraziquantel PrazosinPregabalinPrimidoneProcainamide (HCl)ProchlorperazinePromazine (HCl)Promethazine (HCl)PropiomazineConcurrent use may increase the CNS depressant effects of either these medications. Caution is recommended and dosage of one or both agents should be reduced.PropoxypheneProtriptyline (HCl)Pyrilamine (Maleate)QuetiapineQuinalbarbitone (Na)QuinaprilQuinestrolAcute ingestion of alcohol intake led to a threefold increase in circulating estrasdiol.QuinineRamiprilRauwolfia ReserpineResorcinolConcurrent use with resorcinol may cause a cumulative irritant or drying effect, especially with the application of peeling, desquamating, or abrasive agents, resulting in excessive irritation of the skinRetinol (Vitamin A)RisperidoneSertindoleSertindole has the potential of causing drowsiness, thus in combination Alcohol sedation may result. Sertraline (HCl)Sodium SalicylateSulfapyridineConcurrent use with sulfonamides may result in an increased incidence of hepatotoxicity. Patients, especially those on prolonged administration or those with a history of liver disease.Should be carefully monitored.SulpirideSumatriptanTadalafilConcurrent use can increase the potential for orthostatic signs and symptoms, including increase in heart rate, decrease in standing blood pressure, dizziness, and headache. Technetium Tc-99m lidofeninAlcohol may decrease gallbladder emptying, thus delaying gallbladder clearance of technetium Tc 99m lidofeninTemazepamTenoxicamTerazosinTerfenadineTheophyllineThiethylperazineThiopentone (Na)Thioridazine (HCl)TinidazoleTizanidineTolazoline (HCl)TrandolaprilTrazodone (HCl)TretinoinTriazolamTriclofos (Na)Trifluoperazine (HCl)Trimipramine (Maleate)Triprolidine (HCl)Varicella VaccineVerapamil (HCl)Plasma alcohol concentration possibly increased by verapamil.Warfarin (Na)Enhanced anticoagulant effect with large amounts of alcohol. (Sequence important)Zolpidem (Tartrate)Zuclopenthixol These interactions are sometimes beneficial and sometimes may pose threats to life. Always consult your physician for the change of dose regimen or an alternative drug of choice that may strictly be required.

Liq Store in a well closed container. Protect from Moisture.