 Ethanol is a commonly used medical alcohol. | |
| Clinical data | |
|---|---|
| Routes of administration | Topical,intravenous,by mouth |
| Drug class | Antiseptics,disinfectants,antidotes |
| ATC code | |
| Legal status | |
| Legal status | |
| Pharmacokinetic data | |
| Metabolism | Liver |
| Identifiers | |
| CAS Number | |
| PubChemCID | |
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Alcohols, in various forms, are used medically as anantiseptic,disinfectant, andantidote.[1]Alcohols applied to the skin are used todisinfect skin before aneedle stick and beforesurgery.[2] They may also be used as ahand sanitizer;[2] to clean other areas;[2] and inmouthwashes.[3][4][5] Taken by mouth orinjected into a vein,ethanol is used to treatmethanol orethylene glycol toxicity whenfomepizole is not available.[1]
Side effects of alcohols applied to the skin include skin irritation.[2] Care should be taken withelectrocautery, as ethanol isflammable.[1] Types of alcohol used includeethanol,denatured ethanol,1-propanol, andisopropyl alcohol.[6][7] Alcohols are effective against a range ofmicroorganisms, though they do not inactivatespores.[7] Concentrations of 60% to 90% work best.[7]
95% ABV ethanol is known asspiritus fortis in medical context.
Ablysinol (a brand of 99% ethanol medical alcohol) was sold from $1,300 to $10,000 per 10-pack[Give volume amount please] in 2020 due to FDA administrator action granting exclusivity when used for treatinghypertrophic obstructive cardiomyopathy withalcohol septal ablation in the US through 2025, despite "misuse" of theorphan drug act.[8][9][10][unreliable source?]
Ethanol is listed underAntiseptics, andAlcohol based hand rub underDisinfectants, on theWorld Health Organization's List of Essential Medicines.[6]
Applied to the skin, alcohols are used todisinfectskin before aneedle stick and beforesurgery.[2] They may be used both to disinfect the skin of the person and the hands of the healthcare providers.[2] They can also be used to clean other areas,[2] and inmouthwashes.[3]
Bothethanol andisopropyl alcohol are common ingredients in topical antiseptics, includinghand sanitizer.[11]
Research indicates that alcohol used as pre-surgical antiseptic preparations for ear procedures may have someototoxic properties.[12] In this regard, these alcohol preparations may be considered potentialototoxic medication.
When taken by mouth orinjected into a vein ethanol is used to treatmethanol orethylene glycol toxicity[13] whenfomepizole is not available.[1]
Ethanol, when used for toxicity,competes with other alcohols for thealcohol dehydrogenase enzyme, lessening metabolism into toxicaldehyde andcarboxylic acid derivatives, and reducing more serious toxic effect of the glycols tocrystallize in thekidneys.[14]
Alcohol can intensify the sedation caused byhypnotics/sedatives such asbarbiturates,benzodiazepines,sedative antihistamines,opioids,nonbenzodiazepines/Z-drugs (such aszolpidem andzopiclone).[15]
In theNetherlands,pentobarbital is part of the standard protocol for physician-assisted suicide for self-administration by the patient.[16] It is given in liquid form, in a solution of sugar syrup and alcohol, containing 9 grams of pentobarbital. This is preceded by anantiemetic to prevent vomiting.[16]
Ethanol, often in high concentrations, is used to dissolve many water-insoluble medications and related compounds. Liquid preparations ofpain medications,cough and cold medicines, and mouth washes, for example, may contain up to 25% ethanol[17] and may need to be avoided in individuals with adverse reactions to ethanol such asalcohol-induced respiratory reactions.[18] Ethanol is present mainly as an antimicrobial preservative in over 700 liquid preparations of medicine includingacetaminophen,iron supplements,ranitidine,furosemide,mannitol,phenobarbital,trimethoprim/sulfamethoxazole andover-the-countercough medicine.[19]
Some medicinal solutions of ethanol are also known astinctures.
Usuallymouthwashes areantiseptic solutions intended to reduce the microbial load in the mouth, although other mouthwashes might be given for other reasons such as for theiranalgesic,anti-inflammatory oranti-fungal action. Also, alcohol is added tomouthwash not to destroy bacteria but to act as a carrier agent for essential active ingredients such as menthol, eucalyptol and thymol, which help to penetrate plaque.[20]
A 2020 systematic review and meta-analysis concluded that there is no definitive link between alcohol-based mouthwash use and the risk oforal cancer.[21] This should not be confused with the fact that alcohol consumption at anyquantity is a risk factor foralcohol and cancer such as cancers of themouth,esophagus,pharynx andlarynx.[22]
Absolute ethanol is used as a sclerosant in sclerotherapy. Sclerotherapy has been used "in the treatment of simple pleural effusions, vascular malformations, lymphocytes and seromas."[23]
Ethchlorvynol, developed in the 1950s, was used to treatinsomnia, but prescriptions for the drug had fallen significantly by 1990, as other hypnotics that were considered safer (i.e., less dangerous in overdose) became much more common. Also, ethchlorvynol is not compatible with intravenous injection like ethanol—serious injury (including the loss of limbs due to vascular injury) or death can occur when it is used in this manner.[24] It is no longer prescribed in the United States due to unavailability, but it is still available in some countries and would still be considered legal to possess and use with a valid prescription.
Drinking alcohol willnot prevent or cure COVID-19,[25] contrary to some claims.[26]
Vodka was alleged to be an effective homemade hand sanitizer, or an ingredient in one. The company whose brand was alleged to be protective responded to the rumours by citing the USCenters for Disease Control and Prevention statement that hand sanitizers needed to be at least 60% alcohol to be effective, and stating that their product was only 40% alcohol.[27][28][medical citation needed]
Sinceantiquity, prior to the development of modern agents, alcohol was used as ageneral anesthetic.[29]
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In thehistory of wound care, beer,[30] and wine,[31] are recognized as substances used for healing wounds.
Alcohol has been used as an antiseptic as early as 1363, with evidence to support its use becoming available in the late 1800s.[32]
At times and places of poor public sanitation (such asmedievalEurope), the consumption of alcoholic drinks was a way of avoiding water-borne diseases such ascholera.[33]
Early doctors recognized that ethanol was a risky anesthetic because it could lead to death fromalcohol poisoning or vomit inhalation (pulmonary aspiration). This led to use of alternatives in antiquity, such asopium andcannabis, and laterdiethyl ether starting in the 1840s.[34] As safer options became available, ethanol was eventually phased out as a general anesthetic.
Methylpentynol, discovered 1913, prescribed for the treatment ofinsomnia, but its use was quickly phased out in response to newer drugs with far more favorable safety profiles.[35][36][37] The drug has been replaced bybenzodiazepines and is no longer sold anywhere.[38]
