Alcohol


Concise Prescribing Info
Indications/Uses
Listed in Dosage.
Dosage/Direction for Use
Adult : Parenteral Severe pain; Chronic pain; Trigeminal neuralgia As 100% dehydrated alcohol: 0.2 mL up to a max of 10 mL, given via inj into the nerve root or ganglion ideally located via radiographic or fluoroscopic imaging prior to admin. IV Antidote for methanol or ethylene glycol ingestion As 100% dehydrated alcohol: Loading: 600-800 mg/kg given via infusion over 30 mins thru central venous catheter. Maintenance: 80-83 mg/kg/hr (non-drinker); 120-138 mg/kg/hr (average adult); 184-196 mg/kg/hr (drinker). As 10% ethanol: Loading: 7.5 mL/kg given via infusion over 30 min thru central venous catheter. Maintenance: 0.83 mL/kg/hr (non-drinker); 1.38 mL/kg/hr (average adult); 1.96 mL/kg/hr (drinker). Topical Antiseptic and disinfectant As 70% soln: Clean then apply a small amount on the affected area 1-3 times daily.
Dosage Details
Intravenous
Antidote for methanol or ethylene glycol ingestion
Adult: As 100% dehydrated alcohol: Loading: 600-800 mg/kg given via infusion over 30 mins thru central venous catheter. Maintenance: 80-83 mg/kg/hr (non-drinker); 120-138 mg/kg/hr (average adult); 184-196 mg/kg/hr (drinker). As 10% ethanol: Loading: 7.5 mL/kg given via infusion over 30 min thru central venous catheter. Maintenance: 0.83 mL/kg/hr (non-drinker); 1.38 mL/kg/hr (average adult); 1.96 mL/kg/hr (drinker).
Child: As 100% dehydrated alcohol: Loading: 600-800 mg/kg given via infusion over 30 mins thru central venous catheter. Maintenance: 80-83 mg/kg/hr. As 10% ethanol: Loading: 7.5 mL/kg given via infusion over 30 min thru central venous catheter. Maintenance: 0.83 mL/kg/hr.

Parenteral
Chronic pain, Severe pain, Trigeminal neuralgia
Adult: As 100% dehydrated alcohol: 0.2 mL up to a max of 10 mL, given via inj into the nerve root or ganglion ideally located via radiographic or fluoroscopic imaging prior to admin.

Topical/Cutaneous
Antiseptic and disinfectant
Adult: As 70% soln: Clean then apply a small amount on the affected area 1-3 times daily.
Renal Impairment
IV
Antidote for methanol or ethylene glycol ingestion As 100% dehydrated alcohol: Loading: 600-800 mg/kg given via infusion over 30 mins thru central venous catheter. Maintenance during dialysis: 200-213 mg/kg/hr (non-drinker/child); 240-268 mg/kg/hr (average adult); 308-326 mg/kg/hr (drinker). As 10% ethanol: Loading: 7.5 mL/kg given via infusion over 30 mins thru central venous catheter. Maintenance during dialysis: 2.13 mL/kg/hr (non-drinker/child); 2.68 mL/kg/hr (average adult); 3.26 mL/kg/hr (drinker).
Contraindications
Seizure, diabetic coma. Concomitant use w/ opioid preparations.
Special Precautions
Patient w/ DM, gout, shock. Patient who underwent recent cranial surgery. Hepatic and renal impairment. Childn. Pregnancy and lactation.
Adverse Reactions
Nervous: Headache, dizziness, tremor, lethargy, amnesia, stupor, coma, loss of judgement, emotional lability, slurred speech, ataxia, dysarthia.
CV: Cardiomyopathy, hypotension, HTN, CV collapse.
GI: Nausea, vomiting.
Resp: Resp depression.
Endocrine: Hypoglycaemia.
Musculoskeletal: Muscle incoordination.
Ophthalmologic: Visual impairment, nystagmus.
Others: Hypothermia.
IV/Parenteral: C
Patient Counseling Information
This drug may cause dizziness, if affected, do not drive or operate machinery.
MonitoringParameters
Monitor blood ethanol levels 1-2 hrly until steady state (100-150 mg/L) is reached, then 2-4 hrly thereafter. Monitor for signs and symptoms of CNS and resp depression. Monitor for methanol/ethylene glycol blood levels, blood glucose, arterial pH, blood gases, heart rate, and BP.
Overdosage
Symptoms: CNS depression. Management: Symptomatic and supportive treatment. Employ gastric lavage or aspiration for acute poisoning. Maintain fluid balance w/ suitable electrolyte solutions. Treat hypoglycaemia w/ glucose.
Drug Interactions
May cause unpleasant disulfiram-like reactions w/ chlorpropramide, metronidazole and some cephalosporins. May cause hypoglycaemia w/ sulphonylurea and insulin. May cause orthostatic hypotension w/ vasodilators (e.g. ACE inhibitors, adrenergic neuron blockers, β-blockers).
Potentially Fatal: May enhance the effect of CNS depressants (e.g. hypnotics, sedatives, antihistamines, muscle relaxants, opioid analgesics, antiepileptics, antidepressants, antipsychotics).
Action
Description: Alcohol is widely used as antiseptic and disinfectant due to its ability to denature proteins. It is bacteriostatic at low concentration and bactericidal at high concentration. As an antidote, it competitively inhibits alcohol dehydrogenase, an enzyme which catalyzes the metabolism of ethylene glycol and methanol into toxic metabolites. As a neurolytic, it causes protractive or even permanent anaesthesia by destroying nerves at inj site.
Pharmacokinetics:
Absorption: Rapidly absorbed from the GI tract. Rate of absorption is affected by food, concentration, carbonation, and the time of ingestion. Its vapour can be absorbed through the lungs.
Distribution: Distributed throughout body fluids. Readily crosses the placenta and appears in breast milk, sweat, and other secretions. Volume of distribution: 0.6-0.7 L/kg.
Metabolism: Metabolised in the liver by alcohol dehydrogenase into acetaldehyde and further oxidised into acetate via a microsomal oxidising system.
Excretion: Via kidneys and lungs (approx 2% as unchanged).
Chemical Structure

Click on icon to see table/diagram/image
Storage
Store below 25°C. Protect from light.
Disclaimer: This information is independently developed by MIMS based on Alcohol from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2020 MIMS. All rights reserved. Powered by MIMS.com
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