Interactions between alcohol and drugs: focus on drugs used to treat diseases of the cardiovascular system, gastrointestinal tract, antimicrobial drugs


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Аннотация

According to the 2019 National Survey on Drug Use and Health, 85.6 percent of people ages 18 and older reported driank alcohol at some point in their lives, 69.5 percent reported. that they drank alcohol in the last year and 54.9 percent reported that they drank alcohol in the last month. Also, in the US in 2015-2016, 45.8% of the population used at least one prescription drug in the past 30 days, most of which belonged to the drugs used for the treatment of cardiovascular diseases and antibiotics. Potentially, these drugs can enter into pharmacodynamic or pharmacokinetic interactions. For example, a suppression of activity of alcohol dehydrogenase in the stomach due to consumption of acetylsalicylic acid, that can lead to an increase in Cmax and average AUC of ethanol, and therefore- to increase its toxicity! Another example of an interaction is a decrease in the serum concentration of amiodarone and a decrease in its effectiveness due to the consumption of a large doses or long-term use of ethanol. Alcohol can also affect the effectiveness of antibiotic therapy. For example, ethanol can change the rate, but not the degree of absorption of amoxicillin; reduce Cmax and AUC of erythromycin; increase the bioavailability of tetracycline. Thus, the risks of complications or insufficient effectiveness are extremely high in patients taking alcohol and drugs at the same time for the treatment of diseases of the cardiovascular system, gastrointestinal tract or infectious diseases. To reduce the risks of complications, the potential interactions of alcohol and drugs should be taken into account when choosing drug therapy, but it is still more effective strategies to exclude the combined use of alcohol and drugs.

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Авторлар туралы

A. Pereverzev

Russian Medical Academy of Continuous Professional Education

O. Ostroumova

Russian Medical Academy of Continuous Professional Education; I.M. Sechenov First Moscow State Medical University

Dr. Sci. (Med.), Professor of the Department of Clinical Pharmacology and Propedeutics of Internal Diseases; Professor of the Department of Therapy and Polymorbid Pathology n.a. Academician M.S. Vovsi

D. Sychev

Russian Medical Academy of Continuous Professional Education

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