Lack of potentiation by cetirizine of alcohol-induced psychomotor disturbances

The possible interaction between cetirizine 2 HCl and alcohol was studied in a double-blind, cross-over trial in 36 healthy volunteers. The performance of each volunteer was tested with a battery of five objective psychometric tests, and their subjective feelings were evaluated by visual analogue scales, and by extensive questionnaire. The psychomotor performance and subjective inventory of health was significantly impaired by alcohol intake. Cetirizine 2 HCl was not different from placebo. There was no adverse interaction between cetirizine 2 HCl and alcohol. Cetirizine and alcohol did not modify each others blood levels.

Clinical experience with 781 cases of alcoholism evaluated and treated on an inpatient basis by various methods

A retrospective study of 781 alcoholics detoxified at two treatment centers suggested that magnesium sulfate was significant in preventing seizures and that benzodiazepines were essential in minimizing other complications. Future investigations should determine the most effective mineral dosage levels for alcohol detoxification.

Pre-operative alcohol infusion. The need for analgesic supplementation in chronic alcoholics

The influence of pre-operative alcohol infusion on the requirement for analgesic supplementation with fentanyl in chronic alcoholic patients was studied. The chronic alcoholic was defined as a person having a regular daily alcohol consumption of over 70 g pure alcohol for at least 3 years. The mean annual consumption in the patients studied was 52 litres pure alcohol. A positive correlation between requirement for fentanyl and alcohol consumption was found. The amount of fentanyl required to achieve satisfactory analgesia (the 'saturation dose') was significantly higher (61%) in alcoholic than in non-alcoholic patients. Once stable anaesthesia was achieved the maintenance dose was the same in alcoholic and non-alcoholic patients. Pre-operative infusion of alcohol significantly reduced the amount of fentanyl required to achieve anaesthesia in both alcoholic and non-alcoholic patients (by 25% and 29% respectively). Furthermore it prevented some of the catecholamine mediated effects, such as increase in blood pressure, heart rate and blood glucose.

Blood concentrations and clinical findings following overdose of chlordiazepoxide alone and chlordiazepoxide plus ethanol

Blood concentrations and clinical findings in 25 cases of overdose involving chlordiazepoxide (CDZ) alone ("pure") were compared with those in 23 cases of overdose involving ethanol in addition to CDZ ("mixed"). Both groups consisted predominantly of men who were chronic alcoholics. The mean blood CDZ concentrations did not show statistically significant difference between the two groups ("pure," 5 mg/L; "mixed," 6 mg/L). Following "pure" ingestion, patients were usually alert, and the level of consciousness showed no statistically significant correlation with the blood CDZ concentration. In contrast, after "mixed" ingestion patients were usually lethargic, and the level of consciousness correlated significantly with the blood CDZ concentration (P less than 0.05) but not with the blood ethanol concentration. In neither group was coma noted. For both groups the most common physical findings were tachycardia and dysarthria. Nystagmus was much more common following "mixed" ingestion while seizures, hyperreflexia, and hypertension were more frequent after CDZ overdose alone. Most patients were seen only in the emergency room and were discharged. The implications of these findings are discussed.

The alcoholic patient and surgical stress

In order to find out how the response to operative trauma is influenced by chronic alcohol consumption, 53 patients (28 alcoholics and 25 non-alcoholics) were investigated. The chronic alcoholic was defined as a person having a regular, daily alcohol consumption of over 70 g pure alcohol for at least 3 years. The mean annual consumption in the patients studied was 52 litres pure alcohol (143 ml/day). The investigation was also designed to determine whether the pre-operative infusion of alcohol could prevent the withdrawal syndrome and in that way alter the stress response. The results clearly showed a diminished adrenocortical response to surgical stress in alcoholic patients. While it was possible to suppress some catecholamine-mediated withdrawal symptoms by pre-operative alcohol infusion this did not influence the stress response in any way. It is concluded that complications under anaesthesia and in convalescence in alcoholic patients are not only the consequence of the withdrawal but rather of the general toxic effects of alcohol especially on the endocrine and metabolic functions.

Acute and subacute effects of diazepam on psychomotor skills: interaction with alcohol

Effects of diazepam and alcohol on psychomotor skills were measured in two trials. In the first one, 200 healthy students volunteered for a double-blind single-dose study. Three doses of diazepam (5, 10 and 20 mg) and alcohol (0.5, 0.8 and 1.2 g/kg) were used alone and combined to construct dose-response graphs. All doses of alcohol impaired divided attention while co-ordinative skills were impaired by the 1.2 g/kg dose. Diazepam alone did not impair reactive or co-ordinative skills whereas the combinations of diazepam and alcohol did so. To further elucidate the subactue effects, a double-blind randomized study was conducted administering 2 and 10 mg of diazepam t.i.d. for two weeks to 18 healthy volunteers. The psychomotor tests were performed on the 7th and 14th days of drug administration, and 0.5 g/kg of alcohol was given on either day. Diazepam 2 mg, alone or with alcohol, did not differ from placebo. 10 mg of diazepam slightly increased reaction times but not reaction mistakes, and impaired both co-ordination and attention. Alcohol did not enhance diazepam effects. We suggest that a development of tolerance to diazepam may compensate the deleterious interaction of the agents found in acute studies.

Diazepam actions and plasma concentrations following ethanol ingestion

In eight normal volunteers, the combination of ethanol (0.5 g/kg) and diazepam (10 mg) administered orally produced a greater decrease in motor performance on a pursuit rotor than diazepam alone. The pharmacologic effect of diazepam was enhanced by 73% and this potentiation was associated with significantly greater diazepam concentrations (p less than 0.01) than after diazepam alone. The failure to observe any increase in the concentrations of the principal metabolite, N-desmethyl diazepam, during the period of enhanced pharmacologic effect precludes any change in the demethylating metabolic process as being responsible. The data suggest (0.10 greater than p greater than 0.05) a trend to a smaller volume of distribution of diazepam when ethanol is administered prior to diazepam ingestion. The subjects showed acute tolerance to the effects of diazepam. Lower plasma concentrations on the ascending side of the plasma diazepam concentration versus time profile were linked with the same pharmacologic responses associated with a greater drug concentration on the descending portion, of the same curve.