Alcohol and drugs a deadly combination

During festivals, it is inevitable that friends and family will drink a few glasses of wine when they get together. At dinners or parties, people often joke when they raise their glasses to persuade others to drink: "Cephalexin and alcohol, just go away." This seemingly exaggerated joke hides real medical risks. The interaction between drugs and alcohol can reduce the efficacy of drugs at the least, or cause poisoning or even death at the worst. Today, we will uncover the scientific principles behind this.

1. How does alcohol affect drug metabolism?

The liver is the main organ for the body to metabolize drugs, and the metabolism of alcohol also relies on the enzyme system in the liver. When alcohol and drugs enter the body at the same time, the two will compete for metabolic resources, leading to two results:

1. Delayed drug metabolism : Alcohol inhibits liver metabolic enzymes (such as CYP450 enzyme system), and the drug cannot be broken down in time, accumulating in the body and causing poisoning;

2. Abnormal alcohol metabolism : Certain drugs (such as cephalosporin antibiotics) can block the decomposition of alcohol, leading to the accumulation of the toxic intermediate acetaldehyde and triggering a violent reaction.

2. These drugs and alcohol are incompatible

1. Cephalosporin antibiotics : the most dangerous " disulfiram-like reaction "

Typical drugs: cefoperazone, ceftriaxone, metronidazole, tinidazole, etc.

Consequences: Even drinking a small amount of alcohol may cause facial flushing, headache, nausea and vomiting, palpitations, and in severe cases, difficulty breathing, shock, and even death.

Scientific explanation: The drug inhibits acetaldehyde dehydrogenase, and the accumulation of acetaldehyde triggers toxic reactions, which is the same principle as the alcohol abstinence drug "disulfiram".

2. Antipyretic analgesics : gastric bleeding and liver damage risk

Typical drugs: aspirin, ibuprofen, acetaminophen (paracetamol).

Consequences: Alcohol dilates the blood vessels in the gastric mucosa and synergistically stimulates the stomach wall with drugs, increasing the risk of gastric ulcers and gastric bleeding; toxic substances produced during the metabolism of acetaminophen can lead to acute liver necrosis.

3. Antihypertensive and hypoglycemic drugs: hidden dangers of losing control of efficacy

Antihypertensive drugs (such as nifedipine): Alcohol dilates blood vessels, and the synergistic effect may cause a sudden drop in blood pressure and trigger fainting.

Antidiabetic drugs (such as metformin, insulin): Alcohol inhibits hepatic gluconeogenesis and increases the risk of hypoglycemic coma.

4. Sedatives and sleeping pills: the deadly trap of respiratory depression

Typical drugs: diazepam (Valium), estazolam, zopiclone.

Consequences: Alcohol enhances the drug's inhibitory effect on the central nervous system, causing drowsiness, coma, respiratory arrest, and a very high mortality rate.

5. Antidepressants: emotional and physiological dangers

Typical drugs: sertraline, fluoxetine, monoamine oxidase inhibitors (MAOIs).

Consequences: Alcohol exacerbates the drug's interference with the nervous system, which may induce mania, epileptic seizures, and even hypertensive crisis.

3. “ Hidden Alcohol ” That’s Easily Ignored

In addition to liquor, beer, and wine, the following situations may also cause risks:

Foods containing alcohol: chocolate with alcohol filling, fermented bean curd, drunken shrimp/crab;

Drugs containing ethanol: Huoxiang Zhengqi water, Shidi Shui, compound licorice oral liquid;

External disinfectant alcohol: may be absorbed through the skin after large amounts of skin rub (but the risk is low).

4. The “ Time Rule ” for Safe Medication Use

1. How long after drinking can I take medicine?

Beer/red wine: at least 6 hours apart;

Strong liquor: at least 24 hours apart.

2. How long after stopping medication can I drink alcohol?

Cephalosporin antibiotics: Do not drink alcohol within 7 days after stopping medication;

Sedatives: more than 3 days after discontinuation of medication.

5. Emergency treatment of accidental drinking

1. Stop drinking immediately and drink plenty of water to promote excretion;

2. If you experience symptoms such as flushed face and palpitations, lie flat and keep your breathing unobstructed;

3. If you experience confusion or difficulty breathing, call emergency services immediately and tell your doctor what medications you are taking.

6. Three iron laws of scientific medication

1. Read the instructions before taking the medicine: pay special attention to the "contraindications" and "drug interactions" sections;

2. Actively inform doctors of drinking habits: patients with chronic diseases need to have their liver and kidney function evaluated;

3. Refuse to rely on luck: Even "a small drink" may cost you dearly.

Conclusion

The interaction between drugs and alcohol is essentially a "war" of chemicals in the human body. Every time you take the risk of drinking, it may turn treatment into harm. Remember: health is no small matter, please say "no" to alcohol while taking medication!

Author: Li Yao, Chief Pharmacist, Nansha Branch of Guangzhou First People's Hospital