Excretion of Alcohol in the Urine as a Guide to Alcoholic Intoxication

Pharmacokinetics of ethanol: a review

The pharmacokinetics of ethanol in man are reviewed from a historical perspective from the earliest attempts at kinetic analysis of urinary data in 1899 to the present nonlinear analysis of blood alcohol concentration (BAC) and time data. Review of the various kinetic theories that have been utilized to describe the kinetics of alcohol metabolism is provided. Extensive review is made of recent investigations supporting the application of Michaelis-Menten enzyme kinetics to describe alcohol metabolism. Results of direct, nonlinear least-squares computer fitting of BAC following intravenous and oral feeding of alcohol both in the fasting and fed states are presented with appropriate theory. The kinetics of the oral absorption of alcohol and the relationship among stomach emptying rate, the apparent absorption rate, and the area under the BAC-time curve are discussed and data presented. The kinetics of multiple Michaelis-Menten pathways are discussed with application to the (potential) contributions of the MEOS and/or ADH systems to the observed BAC curve and resultant kinetic parameters. Several methods of obtaining pharmacokinetic (Michaelis-Menten) parameters from BAC curves and their interpretation and usage in comparative studies are presented.

ALCOHOL LEVELS IN BODY FLUIDS AFTER INGESTION OF DISTILLED SPIRITS

Known volumes of 70-proof distilled spirits were fed to 68 volunteers, making a total of 141 separate doses. The amount of alcohol appearing in the venous blood, saliva, and urine at various time intervals after ingestion was determined by a modified Widmark method, and in the breath by the Breathalyzer. The relationship between time after ingestion, venous blood alcohol concentration (VBA), and Breathalyzer reading (BR) was as follows:(1) between 0.5 and 2.5 hours after ingestion, VBA = (BR + 0.048) ± 0.124 mg/ml;(2) between 30 to 40 minutes after ingestion, VBA = (BR − 0.071) ± 0.065 mg/ml;(3) between 2 to 2.5 hours after ingestion, VBA = (BR + 0.102) ± 0.117 mg/ml. The weighted average ratios of saliva and urine alcohols to venous blood alcohol were 1.12:1 and 1.24:1, respectively. The standard error of estimating the venous blood alcohol indirectly from the saliva alcohol was ±0.075 mg/ml, and from urine alcohol ±0.081 mg/ml when the samples were obtained from 0.5 to 2.5 and from 0.75 to 2.5 hours after drinking, respectively. Over the range of concentrations studied alcohol disappeared from the venous blood at the rate of 0.13 ±0.05 mg/ml/hr and the quantity eliminated from the whole body, per 100 lb of body weight per hour, approximated 0.4 fl. oz of 70-proof distilled spirits.

ALCOHOL LEVELS IN BODY FLUIDS AFTER INGESTION OF DISTILLED SPIRITS

Known volumes of 70-proof distilled spirits were fed to 68 volunteers, making a total of 141 separate doses. The amount of alcohol appearing in the venous blood, saliva, and urine at various time intervals after ingestion was determined by a modified Widmark method, and in the breath by the Breathalyzer. The relationship between time after ingestion, venous blood alcohol concentration (VBA), and Breathalyzer reading (BR) was as follows:(1) between 0.5 and 2.5 hours after ingestion, VBA = (BR + 0.048) ± 0.124 mg/ml;(2) between 30 to 40 minutes after ingestion, VBA = (BR − 0.071) ± 0.065 mg/ml;(3) between 2 to 2.5 hours after ingestion, VBA = (BR + 0.102) ± 0.117 mg/ml. The weighted average ratios of saliva and urine alcohols to venous blood alcohol were 1.12:1 and 1.24:1, respectively. The standard error of estimating the venous blood alcohol indirectly from the saliva alcohol was ±0.075 mg/ml, and from urine alcohol ±0.081 mg/ml when the samples were obtained from 0.5 to 2.5 and from 0.75 to 2.5 hours after drinking, respectively. Over the range of concentrations studied alcohol disappeared from the venous blood at the rate of 0.13 ±0.05 mg/ml/hr and the quantity eliminated from the whole body, per 100 lb of body weight per hour, approximated 0.4 fl. oz of 70-proof distilled spirits.