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Medical and Nutritional Complications of Alcoholism pp 165–183Cite as

Interaction of Ethanol with Other Drugs

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Abstract

An “interaction” between alcohol and a drug is any alteration in the pharmacological properties of either because of the presence of the other. Interactions may be (1) antagonistic—the effect of either or both agents is blocked or reduced; (2) additive—the net effect of the combination is the sum of the effects of the individual agents; or (3) supraadditive (synergistic or potentiating)—the effect of the two agents in combination is greater than it would be if they were merely additive. Hypersensitivity is another type of drug interaction. It can occur in alcoholics or heavy drinkers whose alcohol-related pathologies may make them especially sensitive to other drugs. Chronic alcohol use can also produce tolerance; that is, a fixed amount of alcohol in the chronic alcohol abuser has less of an effect than it would in the nonchronic user. In cross-tolerance, a fixed amount of another drug has less of an effect in the alcohol user than in a nonuser. Indeed, chronic alcoholic patients have an increased tolerance to a variety of drugs when sober but a paradoxically increased susceptibility to them when intoxicated. These changes in the susceptibility to drugs are a result of changes in their rates of metabolism as well as of adaptive and synergistic effects of the drug on the primary site of action. Conversely, some effects are caused by the drugs’ inhibition of alcohol metabolism. The latter effects of drugs on ethanol metabolism have been discussed in Chapter 1.

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Lieber, C.S. (1992). Interaction of Ethanol with Other Drugs. In: Medical and Nutritional Complications of Alcoholism. Springer, Boston, MA. https://doi.org/10.1007/978-1-4615-3320-7_6

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