ALCOHOLS

DR.RAMYA RAVICHANDAR
What to learn?
1. ETHANOL
2. METHANOL

PHARMACOKINETI PHARMACODYNAM
CS ICS

DEPENDENCE TREATMENT
Ethyl alcohol
 C2H5OH
 Manufactured by fermentation of sugars
 Actions:
Respiration
 Local
GIT
 CNS Liver
 CVS Skeletal muscle
 Blood Kidney
 Body temperature Sex
Endocrine effects
PHARMACODYNAMICS

LOCAL ACTIONS
CNS
 A L
AW
T H DR
W I
CVS
Small doses Moderate doses

Large doses
Blood Respiration
 Anaemia  Respiratory stimulant
 Megaloblastic in collapse
anaemia  Irritation
 Small to moderate
intake: raises HDL
Body temperature
GIT
Liver
Skeletal muscle Kidney
 Fatigue allayed- small  Diuresis
doses
Endocrine effects

 Acute intoxication:
Hypoglycemia ( GNG)
 PHARMACOKINETI
CS

METABOLIS
M

Alcohol Aldehyde
Ethyl alcohol Acetaldehyde Acetic acid
dehydrogenase dehydrogenase

CO2 + H2O
PHARMACOKINETI
CS

ELIMINATIO
N
Zero order kinetics

BREATH ANALYSER??
Contraindications

y n dro me
oh o l s
Fo etal alc
Acute alcohol intoxication
 Unresponsiveness
 Hypotension
 Hypoglycemia
 Respiratory depression
 Coma
 Death
Treatment of acute alcohol intoxication

 Airway patency
 Fluid and electrolyte balance
 Correction of hypoglycemia
 Thiamine (100mg in 500ml dextrose i.v.)
Chronic alcoholism
 Tolerance :
 Pharmacokinetic tolerance
 Cellular tolerance
 Dependence:
 Psychic
 Physical
 Nutritional deficiencies
Withdrawal syndrome
 Physical dependence

SYMPTOMS:
Treatment of alcohol dependence

Disulfiram
Naltrexone
Acamprosate
DISULFIRAM
 Aldehyde dehydrogenase inhibitor
 Alcohol acetaldehyde
Naltrexone
 Opioid antagonist
 Opioid system-Dopaminergic reward system
 Prevents relapse
 After withdrawal
Acamprosate
 NMDA receptor antagonist
 Given after alcohol withdrawal
 A/E: diarrhoea
Interactions
 Marked CNS depression with antidepressants,
anxiolytics, antihistaminics, opioids
 Disulfiram- like reaction with alcohol:
 Metronidazole
 Sulfonylureas
 Cefoperazone
 Acute intake: microsomal enzyme inhibition
 Chronic intake: microsomal enzyme induction
 Marked hypoglycemia with Insulin/ Sulfonylureas
 Gastric bleeding with Aspirin/ NSAIDs
Methyl alcohol/ Methanol

Acidosis
Retinal damage