ETHANOL, ALCOHOL, ETHYL, ETHYL ALCOHOL

Chemistry - A transparent, colorless, volatile liquid having a characteristic odor and a burning taste, ethyl alcohol is miscible with water and many other solvents.

Storage, Stability, Compatibility

Alcohol should be protected from extreme heat or fromfreezing. Do not use unless the solution is clear. Alcohol may precipitate many drugs, do notadminister other medications in the alcohol infusion solution unless compatibility is documented(see Trissell or other references for additional information).

Pharmacology - ETHANOL, ALCOHOL, ETHYL, ETHYL ALCOHOL

By competitively inhibiting alcohol dehydrogenase, alcohol can prevent theformation of ethylene glycol to its toxic metabolites (glycoaldehyde, glycolate, glyoxalate, andoxalic acid). This allows the ethylene glycol to be principally excreted in the urine unchanged. Asimilar scenario exists for the treatment of methanol poisoning. For alcohol to be effective however, it must be given very early after ingestion. It is seldom useful if started 8 hours after a significantingestion.

Uses, Indications

The principal use of ethanol in veterinary medicine is in the treatment ofethylene glycol or methanol toxicity. While there is much interest in the use of 4-methyl pyrazolefor ethylene glycol poisoning, alcohol is a readily available and economical alternative when patientspresent within a few hours after ingestion.
Ethyl alcohol is also used in aerosol form as a mucokinetic agent in horses.

Pharmacokinetics - ETHANOL, ALCOHOL, ETHYL, ETHYL ALCOHOL

Alcohol is well absorbed orally, but is administered intravenously for toxicitytreatment. It rapidly distributes throughout the body and crosses the blood-brain barrier. Alcoholcrosses the placenta.

Contraindications, Precautions, Reproductive Safety

Because ethylene glycol and methanolintoxications are life threatening, there are no absolute contraindications to ethanol's use for theseindications.
Alcohol's safety during pregnancy has not been established for short term use. Use only whennecessary.

Adverse Effects, Warnings

The systemic adverse effects of alcohol are quite well known. The
CNS depression associated with the high levels used to treat ethylene glycol and methanol toxicitycan confuse the clinical monitoring of these toxicities. Ethanol's affects on antidiuretic hormonemay enhance diuresis. As both ethylene glycol and methanol may also cause diuresis, fluid andelectrolyte therapy requirements need to be monitored and dealt with. Pulmonary edema may result.
Other adverse affects include pain and infection at the injection site and phlebitis. Extravasationshould be watched for and avoided.
When aerosolized in horses, irritation and bronchoconstriction may result.

Overdosage, Acute Toxicity

If symptoms of overdosage occur, either slow the infusion or discontinue temporarily. Alcohol blood levels may be used to monitor both efficacy and toxicity of alcohol.

Drug Interactions

A disulfiram reaction (tachycardia, vomiting, weakness) may occur if alcoholis used concomitantly with the following drugs: chlorpropamide, metronidazole, furazolidone, cephalosporins having methyltetrazolethiol side chain (cefamandole, cefoperazone, cefotetan, moxalactam). Alcohol may cause additive CNS depression when used with other CNSdepressant drugs (e.g., barbiturates, benzodiazepines, phenothiazines, etc.). Alcohol mayaffect glucose metabolism and affect insulin or oral antidiabetic agents effect. Alcohol may increase the severity of side effects seen with bromocriptine.