Interaction of Ethanol with Other Drugs

Deitrich, Richard A.; Petersen, Dennis R.

doi:10.1007/978-1-4684-4436-0_9

Cited by 4 publications

(6 citation statements)

References 81 publications

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“…Effects on respiratory depression also are synergistic. This has important clinical implications; patients can die after ethanol and PB ingestion, with mean ethanol levels found to be ∼175 mg/dl (19).…”

Section: Alcoholmentioning

confidence: 99%

“…Chronic alcoholics may require higher AED doses because of the enhanced clearance rates and more frequent, smaller AED doses to maintain therapeutic serum concentrations. For example, with VPA, both enzyme induction and protein binding must be considered when serum concentrations are interpreted because VPA has variable protein binding and, like other drugs, its clearance is related to free rather than total levels (19,29). Similarly, with CBZ, autoinduction of the enzyme system and changes in protein binding must be considered when interpreting serum concentrations (19,23).…”

Section: Alcoholmentioning

confidence: 99%

“…For example, with VPA, both enzyme induction and protein binding must be considered when serum concentrations are interpreted because VPA has variable protein binding and, like other drugs, its clearance is related to free rather than total levels (19,29). Similarly, with CBZ, autoinduction of the enzyme system and changes in protein binding must be considered when interpreting serum concentrations (19,23). An accurate history of a patient's past or present alcohol use or abuse is essential when deciding on an AED.…”

Section: Alcoholmentioning

confidence: 99%

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Alcohol and Marijuana: Effects on Epilepsy and Use by Patients with Epilepsy

Gordon¹,

Devinsky

2001

Epilepsia

162

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We review the safety of alcohol or marijuana use by patients with epilepsy. Alcohol intake in small amounts (one to two drinks per day) usually does not increase seizure frequency or significantly affect serum levels of antiepileptic drugs (AEDs). Adult patients with epilepsy should therefore be allowed to consume alcohol in limited amounts. However, exceptions may include patients with a history of alcohol or substance abuse, or those with a history of alcohol-related seizures. The most serious risk of seizures in connection with alcohol use is withdrawal. Alcohol withdrawal lowers the seizure threshold, an effect that may be related to alcohol dose, rapidity of withdrawal, and chronicity of exposure. Individuals who chronically abuse alcohol are at significantly increased risk of developing seizures, which can occur during withdrawal or intoxication. Alcohol abuse predisposes to medical and metabolic disorders that can lower the seizure threshold or cause symptoms that mimic seizures. Therefore, in evaluating a seizure in a patient who is inebriated or has abused alcohol, one must carefully investigate to determine the cause. Animal and human research on the effects of marijuana on seizure activity are inconclusive. There are currently insufficient data to determine whether occasional or chronic marijuana use influences seizure frequency. Some evidence suggests that marijuana and its active cannabinoids have antiepileptic effects, but these may be specific to partial or tonic-clonic seizures. In some animal models, marijuana or its constituents can lower the seizure threshold. Preliminary, uncontrolled clinical studies suggest that cannabidiol may have antiepileptic effects in humans. Marijuana use can transiently impair short-term memory, and like alcohol use, may increase noncompliance with AEDs. Marijuana use or withdrawal could potentially trigger seizures in susceptible patients.

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Section: Alcoholmentioning

confidence: 99%

Section: Alcoholmentioning

confidence: 99%

Section: Alcoholmentioning

confidence: 99%

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Alcohol and Marijuana: Effects on Epilepsy and Use by Patients with Epilepsy

Gordon¹,

Devinsky

2001

Epilepsia

162

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“…At the least, ethanol, even in small quantities, when combined with CNS depressants produces undesirable and sometimes dangerous additive effects, especially in light of these uncertain pharmacokinetic or CNS sensitivity changes (Table 1). 7 …”

Section: Central Nervous System Depressants and Alcoholmentioning

confidence: 99%

“…Since both ethanol and phenobarbital cause stimulation of hepatic microsomal enzymes, any interacting effect could alter the action of either or both of these drugs. Animal studies indicate that the aging process introduces a lag period prior to the initiation of hepatic enzyme induction, 7 with the clinical implication that enhanced sensitivity to barbiturates may be based solely on aging.…”

Section: Central Nervous System Depressants and Alcoholmentioning

confidence: 99%

Complications of Alcohol Use Combined with Drug Therapy in the Elderly

Gerbino¹

1982

J American Geriatrics Society

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Chronic ingestion of ethanol in alcoholic beverages can impair drug therapy, lead to sometimes hazardous interactions, or compromise adherence to a well-planned drug treatment program. Various drugs consistently interact with alcohol: CNS depressants, such as benzodiazepines, barbiturates, muscle relaxants, antihistamines, and psychotropic agents; analgesics, including aspirin and narcotics; anticoagulants and other cardiovascular drugs, namely digitalis glycosides, diuretics, antihypertensives, and antiarrhythmics; and antidiabetic agents. Abstinence from alcohol by elderly patients receiving these drugs is recommended.Since 95 million Americans consume alcoholic beverages on a regular basis and approximately 9 million more are alcohol-dependent,' it comes as no surprise that 61 per cent of persons over the age of 50 drink alcohol. In addition, the use of medications by the elderly is twice that of younger counterparts, and accounts for well over 25 per cent of all prescription and over-the-counter drug purchases in the United States.* This is substantial when one considers that those 65 years old or older represent only 11 per cent of the population of the United States.Elderly patients visiting private physicians regularly receive or renew at least one or two prescription drugs per visit. Patients in nursing homes are routinely maintained on four to six medications. Studies of prescribing patterns in hospitals and private offices indicate that cardiovascular agents, diuretics, aspirin and narcotic-containing analgesics, and psychotropics are the classes of drugs most frequently prescribed for elderly patientsS3s4 These agents also account for the greatest number of drug-related hospital admissions of the elderlya5 It is a sobering coincidence that clinically troublesome drug-alcohol interactions occur with the same classes of drugs.Alcohol use may lead to a variety of metabolic and organ system derangements. It can impair the effectiveness of routine drug therapy, or actively create new medical problems requiring additional therapy. Excessive alcohol use in association with medications in the elderly can severly compromise and complicate a well-planned therapeutic program. Even the moderate or intermittent use of alcohol can be harmful if the patient is taking certain of the potentially interacting drugs.

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Mechanisms of Depressant Drug Action/Interaction

Schoener

1986

Recent Developments in Alcoholism

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Interaction of Ethanol with Other Drugs

Cited by 4 publications

References 81 publications

Alcohol and Marijuana: Effects on Epilepsy and Use by Patients with Epilepsy

Alcohol and Marijuana: Effects on Epilepsy and Use by Patients with Epilepsy

Complications of Alcohol Use Combined with Drug Therapy in the Elderly

Mechanisms of Depressant Drug Action/Interaction

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