Alcoholic beverages are so common in everyday life that combination with medicines is not uncommon. Interactions rarely have obvious negative consequences, but are far from safe. Patients with multiple illnesses who take drugs are at risk of alcohol interactions.
Psychotropic substances and alcohol: why incompatible?
The effect of alcohol is enhanced by drugs with a depressant effect on the central nervous system. Tranquilizers, sleeping pills, sedative antidepressants, antihistamines, antipsychotics, antiepileptic or opioids increase the risk of alcohol poisoning.
There are cases when the simultaneous use of corvalol and ethyl alcohol became the cause of coma. Diazepam, oxazepam, alprazolam - benzodiazepines, which inhibit the nervous system in the same way as alcohol.
Why is aspirin, metoclopramide, and cisapride with alcohol a bad combination?
Both ethyl alcohol and acetylsalicylic acid are caused damage to the mucous membrane of the stomach. Although the interaction is poorly documented, the combination of alcohol with aspirin is not uncommon. the cause of internal bleeding.
In the small intestine, unlike the stomach, alcohol is absorbed very quickly. The rate of gastric emptying affects blood alcohol levels. Cisapride, metoclopramide, and erythromycin increase gastric motility, so they can increase blood alcohol levels. Cigarette smoking slows the emptying of the stomach and therefore the absorption of alcohol.
Alcohol is processed primarily in the liver. The enzyme that breaks down alcoholic beverages is alcohol dehydrogenase. If less alcohol remains in the stomach for a longer time, it is processed by the enzyme.
However, the importance of this phenomenon is controversial. Interaction with drugs that block alcohol has little effect on people. It is possible that these drugs in the context of "social drinking" lead to higher levels of alcohol, which are of practical importance (driving ability, for example).
Therefore, careful advice is not to drink alcohol with aspirin or histamine receptor blockers. The reduced activity of alcohol dehydrogenase observed in people with Helicobacter infection slows the breakdown of alcohol.
How do drugs affect alcohol processing?
Halotane, enflurane, isoniazidi and paracetamol are partially processed by the liver. Therefore, ethyl alcohol under their influence is rapidly excreted. However, the "processing" of drugs is also accelerated and especially pronounced. In this way, toxic effects of paracetamol especially observed in individuals with chronic alcohol abuse.
The liver enzyme CYP2E1 has the unusual property of generating reactive oxygen intermediates with toxic properties. It can convert industrial solvents into toxic metabolites. The activity of the enzyme is enhanced by alcohol.
Acetaldehyde (a breakdown product of alcohol) is also very toxic and is usually processed by the liver. Alcohol-destroying enzyme is absent in Asia in 25-50% of the population. In these people, even a small amount of alcohol can cause palpitations, headache, and nausea.
Aldehyde dehydrogenase activity is also reduced in patients with chronic alcohol abuse. Disulfiram is used to block the enzyme that breaks down alcohol. As a result, it accumulates in the body and causes toxic reactions.
Chlorpropamide and various antibiotics also can slow down the breakdown of alcohol. As a result, the concentration of the toxic decay product increases.
Female hormones and antidiabetic drugs with alcohol - a deadly combination
In postmenopausal women taking estradiol, a mixed alcoholic drink led to a sharp increase in estrogen levels in the blood. The mechanism of this interaction is unknown, but proven.
Animal studies have revealed new negative effects of alcohol. Scientists have suggested that alcohol when administered with metformin increases the risk of lactic acidosis.
