ALCOHOL

Alcohol are defined as hydroxyl derivatives of aliphatic hydrocarbon. They contains one or more hydroxyl group and can be classified as

  1. Monohydroxy alcohol :- eg. Ethyl alcohol, Methyl alcohol, Propyl alcohol
  2. Dihydroxy alcohol :- eg.Glycerol
  3. Polyhydroxy alcohol :- eg. Mannitol, Sorbitol 
When unqualified alcohol generally refers to ethyl alcohol or ethanol


Type of alcohol beverages

  1. Spirits :- these are distilled beverage and include rum, gin, whisky, brandy and vodka . spirits usually contains 40 % or more than 40 % alcohol.
  2. Malted liquor/Beverages:- These are generally undistilled beverages and contains less amount of alcohol. eg. Beers usually contains 3-6% v/v of alcohol
  3. Wine Beverages:- They are also undistilled beverages like malted liquors natural sugar of grapes fermentation wines.

                                                          Wines 

Based on alcohol content

  1. Light wines;- 9-12% alcohol 
  2. Effervescent wines ;- 12-16 % alcohol
  3. fortified wines :- 16-22% alcohol  

Base on sugar content


  1. Dry wines :- Sugar entirely fermented
  2. Sweet wines :- Some amount of unfermented 
Mechanism of action 
  •    Ethanol is known to exhibit several modes of actions all  of which ultimately cause CNS depression apart from exerting its effects on receptors, alcohol also affects membrane proteins, enzymes such as phospholipases, adenyl cyclase and ion channels.
  • Alcohol promotes the action of inhibitory neurotransmitters GABA on GABAa receptors and inhibits the activity of excitatory neurotransmitters i.e. glutamate on NmDA receptors
  • CNS effects of alcohol might also occurs due to blockade of voltage gated L-type Ca2+ channels ,
  • Ethanol increases the action of SHT on 5HT3 receptors which is responsible for the inhibitory effects.
  • It also blocks the adenosine uptake.

Pharmacological action


Local effects 

  •  when applied on skin it acts as rubefacients and counterirritant .
  • It rapidly gets evaporated producing cooling effects and refreshing effects, when applied on skin.
  • It also acts as antiseptic by precipitating bacterial proteins.
  • It also effective as an astringent, germicidal agent and as an irritant.

Systemic effects 


On CNS

  • ethanol depresses the CNS and peripheral nervous system by altering neurotransmitter levels , functions.
  • At lower dose, ethanol exerts initial stimulating effect due to less inhibition later at high dose, CNS, depression also increases.
  • Eupheria alteration in mood etc are due to excitation of mesolimbic dopaminergic reward system.

On CVS

  • Ethanol exhibits protective and toxic effects on cardiovascular system. 

On GIT

  • The digestive tract gets irritanted leading to gastric erosions.
  • Because of the excess production of acid gastric distrubance occurs finally causing gastritis .

On hepatic system

  • Chronic consumption of alcohol cause accumulation of fat in liver, leading to hepatitis.
  • Excess intake of alcohol decreases metabolism of fat thus fat gets accumulated in liver causing fatty liver.

On kidney 

  • Alcohol enhances diuresis as it supress the level of ADH  and also enhances amount of water consumed along with alcohol. 

On skeletal system

  • Alcoholic are more susceptible to osteoporosis and osteonecrosis which are metabolic bone diseases.


Pharmacokinetics 

  • Absorption :- When it is consumed on empty stomach, its absorption is rapid because portal vein concentration of ethanol becomes high and much amount of alcohol enters systemic circulation.
  •  Distribution:- The distribution of ethanol is very rapid and concentration of ethanol is high in the areas where blood flow is high.
  • Metabolism:- About 90% of alcohol consumed under goes  metabolism by oxidation in liver and 5-10% gets excreted unchanged term through lungs and urine.

Adverse effects 

  • CNS manifestations
  • CVS manifestations
  • GI manifestations
  • Respiratory manifestations

Uses

  • It relives sprains and joints pains by acting as counter irritant and rubefacient.
  • Used as an antiseptics.
  • It reduces body temperature.
  •  It treatment of trigeminal neuralgia.
  • Use to treat methanol poisoning.

Treatment of alcoholism/ Alcohol Dependence

  • Detoxification which is used to treat withdrawl symptoms.
  • Rehabilitation
             It involves psychotherapy and institutional therapy the drugs used for rehabilitation prevent reoccurance or replaces and ensures complete withdrwl.

The drugs are classified as:
Aversion drugs/ drugs that make ethanol consumption unpleasant.
eg. Disulfiram, Citrated calcium cyanamide
Drugs used to reduce craving.
eg. Naltrexone , Nalnephene, Topiramate.

Supportive drugseg. Carbamazepine, Lithium, Oridansetron, Fluoxetine                        

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