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The American Journal of Geriatric... Mar 2007Many older adults (ie, those aged >65 years) drink alcohol and use medications that may be harmful when consumed together. (Review)
Review
BACKGROUND
Many older adults (ie, those aged >65 years) drink alcohol and use medications that may be harmful when consumed together.
OBJECTIVE
This article reviews the literature on alcohol and medication interactions, with a focus on older adults.
METHODS
Relevant articles were identified through a search of MEDLINE and International Pharmaceutical Abstracts (1966-August 2006) for English-language articles. The following medical subject headings and key words were used: alcohol medication interactions, diseases worsened by alcohol use, and alcohol metabolism, absorption, and distribution. Additional articles were identified by a manual search of the reference lists of the identified articles, review articles, textbooks, and personal reference sources.
RESULTS
Many older adults drink alcohol and take medications that may interact negatively with alcohol. Some of these interactions are due to age-related changes in the absorption, distribution, and metabolism of alcohol an medications. Others are due to disulfiram-like reactions observed with some medications, exacerbation of therapeutic effects and adverse effects of medications when combined with alcohol, and alcohol's interference with the effectiveness of some medications.
CONCLUSIONS
Older adults who drink alcohol and who take medications are at risk for a variety of adverse consequences depending on the amount of alcohol and the type of medications consumed. It is important for clinicians to know how much alcohol their older patients are drinking to be able to effectively assess their risks and to counsel them about the safe use of alcohol and medications. Similarly, it is important for older adults to understand the potential risks of their combined alcohol and medication use to avoid the myriad of problems possible with unsafe use of these substances..
Topics: Aged; Aged, 80 and over; Aging; Alcohol Drinking; Alcohol-Related Disorders; Alcoholism; Central Nervous System Depressants; Drug Interactions; Drug-Related Side Effects and Adverse Reactions; Ethanol; Female; Humans; Male; Prevalence
PubMed: 17608249
DOI: 10.1016/j.amjopharm.2007.03.006 -
BMJ (Clinical Research Ed.) Jan 2005
Review
Topics: Alcohol Drinking; Behavior; Ethanol; Gastric Mucosa; Humans; Intestinal Absorption
PubMed: 15637372
DOI: 10.1136/bmj.330.7482.85 -
Alcoholism, Clinical and Experimental... Sep 2011Defining the sites of action of ethanol on brain proteins is a major prerequisite to understanding the molecular pharmacology of this drug. The main barrier to reaching... (Review)
Review
Defining the sites of action of ethanol on brain proteins is a major prerequisite to understanding the molecular pharmacology of this drug. The main barrier to reaching an atomic-level understanding of alcohol action is the low potency of alcohols, ethanol in particular, which is a reflection of transient, low-affinity interactions with their targets. These mechanisms are difficult or impossible to study with traditional techniques such as radioligand binding or spectroscopy. However, there has been considerable recent progress in combining X-ray crystallography, structural modeling, and site-directed mutagenesis to define the sites and mechanisms of action of ethanol and related alcohols on key brain proteins. We review such insights for several diverse classes of proteins including inwardly rectifying potassium, transient receptor potential, and neurotransmitter-gated ion channels, as well as protein kinase C epsilon. Some common themes are beginning to emerge from these proteins, including hydrogen bonding of the hydroxyl group and van der Waals interactions of the methylene groups of ethanol with specific amino acid residues. The resulting binding energy is proposed to facilitate or stabilize low-energy state transitions in the bound proteins, allowing ethanol to act as a "molecular lubricant" for protein function. We discuss evidence for characteristic, discrete alcohol-binding sites on protein targets, as well as evidence that binding to some proteins is better characterized by an interaction region that can accommodate multiple molecules of ethanol.
Topics: Binding Sites; Brain; Central Nervous System Depressants; Ethanol; G Protein-Coupled Inwardly-Rectifying Potassium Channels; Humans; Models, Molecular; Potassium Channels, Inwardly Rectifying; Protein Binding; Proteins
PubMed: 21676006
DOI: 10.1111/j.1530-0277.2011.01502.x -
Journal of the American College of... Jun 2005Excessive alcohol consumption has long been associated with cardiovascular disorders, including cardiomyopathy, hypertension, coronary artery disease, and stroke.... (Review)
Review
Excessive alcohol consumption has long been associated with cardiovascular disorders, including cardiomyopathy, hypertension, coronary artery disease, and stroke. However, recent evidence suggests that moderate alcohol intake can actually provide a measure of cardioprotection, particularly against coronary heart disease and ischemia-reperfusion injury. To explore the various dimensions of these opposing actions of alcohol, the National Institute on Alcohol Abuse and Alcoholism and the National Heart, Lung, and Blood Institute sponsored a state-of-the-art workshop on "Alcohol and the Cardiovascular System: Research Challenges and Opportunities" in Bethesda, Maryland, in May 2003. Speakers discussed the following topics: the epidemiology of alcohol and cardiovascular disease, clinical manifestations of alcohol, genetics of alcohol and cardiovascular disease, mechanisms underlying the molecular and cellular effects of alcohol, the application of new and emerging technology, and translation from discovery to therapeutic modalities of treatment. The panel concluded that future studies are needed to: 1) determine the role of genes and the environment in assessing mechanisms underlying the benefits of alcohol use and cardiovascular disease risk; 2) define the biological mechanisms underlying alcohol-induced peripheral vascular damage; 3) clarify the role of genetic variation in alcohol-metabolizing enzymes, genetic susceptibility, and pharmacogenomics in determining cardiovascular disease risk and effective treatment; 4) determine common mechanisms underlying alcohol-induced cardiovascular disease, such as oxidative stress and inflammation; 5) assess the role of insulin resistance, blood clotting, protein kinase C isoforms, and signal transduction mechanisms mediating alcohol's beneficial effects; and 6) explore the potential of stem cells in myocardial regeneration and repair in hearts damaged by alcohol.
Topics: Alcohol Drinking; Cardiovascular Diseases; Cardiovascular System; Ethanol; Humans
PubMed: 15963387
DOI: 10.1016/j.jacc.2005.02.075 -
Biomolecules Feb 2015Hepatitis C and alcohol are the most widespread causes of liver disease worldwide. Approximately 80% of patients with a history of hepatitis C and alcohol abuse develop... (Review)
Review
Hepatitis C and alcohol are the most widespread causes of liver disease worldwide. Approximately 80% of patients with a history of hepatitis C and alcohol abuse develop chronic liver injury. Alcohol consumption in hepatitis C virus (HCV)-infected patients exacerbates liver disease leading to rapid progression of fibrosis, cirrhosis and even hepatocellular carcinoma. Hepatocytes are the main sites of HCV-infection and ethanol metabolism, both of which generate oxidative stress. Oxidative stress levels affect HCV replication and innate immunity, resulting in a greater susceptibility for HCV-infection and virus spread in the alcoholic patients. In this review paper, we analyze the effects of ethanol metabolism and other factors on HCV replication. In addition, we illustrate the mechanisms of how HCV hijacks innate immunity and how ethanol exposure regulates this process. We also clarify the effects of HCV and ethanol metabolism on interferon signaling-a crucial point for activation of anti-viral genes to protect cells from virus-and the role that HCV- and ethanol-induced impairments play in adaptive immunity which is necessary for recognition of virally-infected hepatocytes. In conclusion, ethanol exposure potentiates the suppressive effects of HCV on innate immunity, which activates viral spread in the liver and finally, leads to impairments in adaptive immunity. The dysregulation of immune response results in impaired elimination of HCV-infected cells, viral persistence, progressive liver damage and establishment of chronic infection that worsens the outcomes of chronic hepatitis C in alcoholic patients.
Topics: Ethanol; Hepacivirus; Humans; Immunity, Innate; Liver; Virus Replication
PubMed: 25664450
DOI: 10.3390/biom5010076 -
International Journal of Molecular... Sep 2021Alcohol is a psychoactive substance that is widely used and, unfortunately, often abused. In addition to acute effects such as intoxication, it may cause many chronic... (Review)
Review
Alcohol is a psychoactive substance that is widely used and, unfortunately, often abused. In addition to acute effects such as intoxication, it may cause many chronic pathological conditions. Some of the effects are very well described and explained, but there are still gaps in the explanation of empirically co-founded dysfunction in many alcohol-related conditions. This work focuses on reviewing actual knowledge about the toxic effects of ethanol and its degradation products.
Topics: Acetaldehyde; Alcohol Dehydrogenase; Alcohol Drinking; Alcohol-Related Disorders; Ethanol; Gene Expression Regulation, Enzymologic; Humans; Metabolic Networks and Pathways; Organ Specificity; Oxidative Stress
PubMed: 34575850
DOI: 10.3390/ijms22189686 -
Alcohol Health and Research World 1998The male reproductive system consists of the hypothalamus, the anterior pituitary gland, and the testes. Alcohol can interfere with the function of each of these... (Review)
Review
The male reproductive system consists of the hypothalamus, the anterior pituitary gland, and the testes. Alcohol can interfere with the function of each of these components, thereby causing impotence, infertility, and reduced male secondary sexual characteristics. In the testes, alcohol can adversely affect the Leydig cells, which produce and secrete the hormone testosterone. Studies found that heavy alcohol consumption results in reduced testosterone levels in the blood. Alcohol also impairs the function of the testicular Sertoli cells that play an important role in sperm maturation. In the pituitary gland, alcohol can decrease the production, release, and/or activity of two hormones with critical reproductive functions, luteinizing hormone and follicle-stimulating hormone. Finally, alcohol can interfere with hormone production in the hypothalamus.
Topics: Alcohol Drinking; Animals; Ethanol; Fertility; Humans; Infertility, Male; Male
PubMed: 15706796
DOI: No ID Found -
Addiction (Abingdon, England) Nov 2022Transdermal alcohol sensors carry immense promise for the continuous assessment of drinking but are inconsistent in detecting more fine-grained indicators of alcohol... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND AND AIMS
Transdermal alcohol sensors carry immense promise for the continuous assessment of drinking but are inconsistent in detecting more fine-grained indicators of alcohol consumption. Prior studies examining associations between transdermal alcohol concentration (TAC) and blood/breath alcohol concentration (BAC) have yielded highly variable correlations and lag times. The current review aimed to synthesize transdermal validation studies, aggregating results from more than three decades of research to characterize the validity of transdermal sensors for assessing alcohol consumption.
METHODS
Databases were searched for studies listed prior to 1 March 2022 that examined associations between transdermal alcohol sensor output and blood and breath-based alcohol measures, resulting in 31 primarily laboratory-derived participant samples (27 precise effect sizes) including both healthy and clinical populations. Correlation coefficients and lag times were pooled using three-level random-effects meta-regression. Independent raters coded study characteristics, including the body position of transdermal sensors (ankle- versus arm/hand/wrist-worn device) and methodological bias (e.g. missing data).
RESULTS
Analyses revealed that, in this primarily laboratory-derived sample of studies, the average correlation between TAC and BAC was large in magnitude [r = 0.87, 95% confidence interval (CI) = 0.80, 0.93], and TAC lagged behind BAC by an average of 95.90 minutes (95% CI = 55.50, 136.29). Device body position significantly moderated both TAC-BAC correlation (b = 0.11, P = 0.009) and lag time (b = -69.41, P < 0.001). Lag times for ankle-worn devices were approximately double those for arm/hand/wrist-worn devices, and TAC-BAC correlations also tended to be stronger for arm/hand/wrist-worn sensors.
CONCLUSIONS
This meta-analysis indicates that transdermal alcohol sensors perform strongly in assessing blood/breath alcohol concentration under controlled conditions, with particular promise for the newer generation of wrist-worn devices.
Topics: Alcohol Drinking; Biosensing Techniques; Blood Alcohol Content; Breath Tests; Ethanol; Humans
PubMed: 35603913
DOI: 10.1111/add.15953 -
The Western Journal of Medicine Oct 1989
Topics: Alcohol Drinking; Cardiomyopathy, Alcoholic; Cardiovascular Diseases; Cardiovascular System; Ethanol; Humans; Hypertension; Risk Factors; Temperance
PubMed: 2588583
DOI: No ID Found -
Alcohol Health and Research World 1998In many alcoholics, the severity of withdrawal symptoms increases after repeated withdrawal episodes. This exacerbation may be attributable to a kindling process.... (Review)
Review
In many alcoholics, the severity of withdrawal symptoms increases after repeated withdrawal episodes. This exacerbation may be attributable to a kindling process. Kindling is a phenomenon in which a weak electrical or chemical stimulus, which initially causes no overt behavioral responses, results in the appearance of behavioral effects, such as seizures, when it is administered repeatedly. Both clinical and experimental evidence support the existence of a kindling mechanism during alcohol withdrawal. Withdrawal symptoms, such as seizures, result from neurochemical imbalances in the brain of alcoholics who suddenly reduce or cease alcohol consumption. These imbalances may be exacerbated after repeated withdrawal experiences. The existence of kindling during withdrawal suggests that even patients experiencing mild withdrawal should be treated aggressively to prevent the increase in severity of subsequent withdrawal episodes. Kindling also may contribute to a patient's relapse risk and to alcohol-related brain damage and cognitive impairment.
Topics: Alcoholism; Animals; Ethanol; Humans; Kindling, Neurologic; Substance Withdrawal Syndrome
PubMed: 15706729
DOI: No ID Found