Alcohol
Skeletal formula of ethanol
Ethanol is a commonly used medical alcohol.
Clinical data
Routes of
administration		Topical, intravenous, by mouth
Drug classAntiseptics, disinfectants, antidotes
ATC code
Legal status
Legal status
Pharmacokinetic data
MetabolismLiver
Identifiers
CAS Number
PubChem CID
DrugBank
ChemSpider
UNII

Alcohols, in various forms, are used within medicine as an antiseptic, disinfectant, and antidote.[1] Alcohols applied to the skin are used to disinfect skin before a needle stick and before surgery.[2] They may be used both to disinfect the skin of the person and as hand sanitizer of the healthcare providers.[2] They can also be used to clean other areas[2] and in mouthwashes.[3][4][5] Taken by mouth or injected into a vein, ethanol is used to treat methanol or ethylene glycol toxicity when fomepizole is not available.[1]

Side effects of alcohols applied to the skin include skin irritation.[2] Care should be taken with electrocautery, as ethanol is flammable.[1] Types of alcohol used include ethanol, denatured ethanol, 1-propanol, and isopropyl alcohol.[6][7] Alcohols are effective against a range of microorganisms, though they do not inactivate spores.[7] Concentrations of 60 to 90% work best.[7]

Alcohol has been used as an antiseptic as early as 1363, with evidence to support its use becoming available in the late 1800s.[8] Commercial formulations of hand sanitizer or with other agents such as chlorhexidine are available.[7][9]

Medical uses

95% ABV ethanol is known as spiritus fortis in medical context.

Antiseptics and disinfectants

Ethanol is listed under Antiseptics, and Alcohol based hand rub under Disinfectants, on the World Health Organization's List of Essential Medicines.[10]

Applied to the skin, alcohols are used to disinfect skin before a needle stick and before surgery.[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 in mouthwashes.[3]

Both ethanol and isopropyl alcohol are common ingredients in topical antiseptics, including hand sanitizer.[11]

Treatment for ethylene glycol toxicity, and methanol toxicity

When taken by mouth or injected into a vein ethanol is used to treat methanol or ethylene glycol toxicity[12] when fomepizole is not available.[1]

Mechanism

Ethanol, when used for toxicity, competes with other alcohols for the alcohol dehydrogenase enzyme, lessening metabolism into toxic aldehyde and carboxylic acid derivatives, and reducing more serious toxic effect of the glycols to crystallize in the kidneys.[13] Ethanol, when used for toxicity, competes with other alcohols for the alcohol dehydrogenase enzyme, lessening metabolism into toxic aldehyde and carboxylic acid derivatives, and reducing more serious toxic effect of the glycols to crystallize in the kidneys.[13]

Sclerosant

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."[14]

Sedative

Ethchlorvynol, developed in the 1950s, was used to treat insomnia, 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. 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.

History

Alcohol has been used as an antiseptic as early as 1363 with evidence to support its use becoming available in the late 1800s.[8] Since antiquity, prior to the development of modern agents, alcohol was used as a general anesthetic.[15]

Methylpentynol, discovered 1913, prescribed for the treatment of insomnia, but its use was quickly phased out in response to newer drugs with far more favorable safety profiles.[16][17][18] The drug has been replaced by benzodiazepines and is no longer sold anywhere.[19]

Society and culture

Economics

As Ablysinol (a brand of 99% ethanol medical alcohol), its pricing is expensive; it's just strong alcohol, but if purchased as a medication for internal use, it went from $1,300 to $10K per 10-pack in 2020, due to FDA administrator action granting exclusivity when used for treating hypertrophic obstructive cardiomyopathy in the US through 2025, despite "misuse" of the orphan drug act.[20][21][22]

References

  1. 1 2 3 4 British National Formulary: BNF 69 (69th ed.). British Medical Association. 2015. pp. 42, 838. ISBN 9780857111562.
  2. 1 2 3 4 5 6 7 World Health Organization (2009). Stuart MC, Kouimtzi M, Hill SR (eds.). WHO Model Formulary 2008. World Health Organization. p. 321. hdl:10665/44053. ISBN 9789241547659.
  3. 1 2 Limeback H (11 April 2012). Comprehensive Preventive Dentistry. John Wiley & Sons. pp. 138–. ISBN 978-1-118-28020-1. Archived from the original on 18 September 2017.
  4. ↑ Kuriakose MA (8 December 2016). Contemporary Oral Oncology: Biology, Epidemiology, Etiology, and Prevention. Springer. pp. 47–54. ISBN 978-3-319-14911-0. Archived from the original on 18 September 2017.
  5. ↑ Jameel RA, Khan SS, Kamaruddin MF, Abd Rahim ZH, Bakri MM, Abdul Razak FB (October 2014). "Is synthetic mouthwash the final choice to treat oral malodour?". Journal of the College of Physicians and Surgeons--Pakistan. 24 (10): 757–762. PMID 25327922.
  6. ↑ "WHO Model List of Essential Medicines (19th List)" (PDF). World Health Organization. April 2015. Archived (PDF) from the original on 13 December 2016. Retrieved 8 December 2016.
  7. 1 2 3 4 McDonnell G, Russell AD (January 1999). "Antiseptics and disinfectants: activity, action, and resistance". Clinical Microbiology Reviews. 12 (1): 147–179. doi:10.1128/cmr.12.1.147. PMC 88911. PMID 9880479.
  8. 1 2 Block SS (2001). Disinfection, Sterilization, and Preservation. Lippincott Williams & Wilkins. p. 14. ISBN 9780683307405. Archived from the original on 13 January 2017.
  9. ↑ Bolon MK (September 2016). "Hand Hygiene: An Update". Infectious Disease Clinics of North America. 30 (3): 591–607. doi:10.1016/j.idc.2016.04.007. PMID 27515139.
  10. ↑ World Health Organization (2019). World Health Organization model list of essential medicines: 21st list 2019. Geneva: World Health Organization. hdl:10665/325771. WHO/MVP/EMP/IAU/2019.06. License: CC BY-NC-SA 3.0 IGO.
  11. ↑ Research Cf (12 May 2023). "Q&A for Consumers | Hand Sanitizers and COVID-19". FDA.
  12. ↑ Mégarbane B (24 August 2010). "Treatment of patients with ethylene glycol or methanol poisoning: focus on fomepizole". Open Access Emergency Medicine : OAEM. 2: 67–75. doi:10.2147/OAEM.S5346. ISSN 1179-1500. PMC 4806829. PMID 27147840.
  13. 1 2 Barceloux DG, Bond GR, Krenzelok EP, Cooper H, Vale JA (2002). "American Academy of Clinical Toxicology practice guidelines on the treatment of methanol poisoning". Journal of Toxicology. Clinical Toxicology. 40 (4): 415–446. doi:10.1081/CLT-120006745. PMID 12216995. S2CID 26495651.
  14. ↑ Episalla NC, Orra S, Black CK, Dekker PK, Kim KG, Cardella JT, et al. (August 2021). "Sclerotherapy as an alternative treatment for complex, refractory seromas". Journal of Surgical Case Reports. Oxford University Press. 2021 (8): rjab224. doi:10.1093/jscr/rjab224. PMC 8384448. PMID 34447570.
  15. ↑ Eger II EI, Saidman LJ, Westhorpe RN (14 September 2013). The Wondrous Story of Anesthesia. Springer Science & Business Media. pp. 4–. ISBN 978-1-4614-8441-7. Archived from the original on 18 September 2017.
  16. ↑ Hirsh HL, Orsinger WH (January 1952). "Methylparafynol--a new type hypnotic. Preliminary report on its therapeutic efficacy and toxicity". American Practitioner and Digest of Treatment. 3 (1): 23–6. PMID 14903452.
  17. ↑ Schaffarzick RW, Brown BJ (December 1952). "The anticonvulsant activity and toxicity of methylparafynol (dormison) and some other alcohols". Science. 116 (3024): 663–5. Bibcode:1952Sci...116..663S. doi:10.1126/science.116.3024.663. PMID 13028241.
  18. ↑ Herz A (March 1954). "[A new type of hypnotic; unsaturated tertiary carbinols; experimental studies on therapeutic use of 3-methyl-pentin-ol-3 (methylparafynol)]". Arzneimittel-Forschung. 4 (3): 198–9. PMID 13159700.
  19. ↑ Hines RD (2002). The Pursuit of Oblivion. p. 327.{{cite book}}: CS1 maint: overridden setting (link)
  20. ↑ Paavola A (12 February 2020). "Why price of dehydrated alcohol is going from $1,300 to $10K". www.beckershospitalreview.com.
  21. ↑ "Biotech executives, having pledged fair pricing, criticize drugmaker for steep hike". BioPharma Dive.
  22. ↑ "Statement on Belcher Pharmaceuticals". linkedin. Retrieved 19 October 2023.
This article is issued from Wikipedia. The text is licensed under Creative Commons - Attribution - Sharealike. Additional terms may apply for the media files.