• What type of kinetics applies for alcohol in the body? Also, explain the clinical significance of this.

Alcohol is lipophilic and therefor has a fast distribution and absorption rate. It can cross the blood brain barrier and be a CNS suppressant. When a person takes alcohol on an empty stomach peak levels can be reached within 30 minutes. The Peak concentrations in women can be reached more easily since men has more fluids in their body to dilute the alcohol. Alcohol is metabolised by the Liver and can activate 2E1 (Induce NAPQI formation when drinking Paracetamol with alcohol).

• Give a brief summary of the metabolic pathways of ethanol metabolism.

Ethanol metabolism occurs via 2 enzyme systems.

1)   Alcohol dehydrogenase system – Usually when there is a low amount of alcohol present in the body. Co-Enzyme NAD breaks down alcohol in acetaldehyde and aldehyde dehydrogenase enzyme converts that into acetate. This system can be saturated.

2) Microsomal ethanol oxidation (Mixed function oxidation) – usually when there is a higher amount of alcohol present in the body. (>100 mg/dL). Alcohol are being broken down into acetaldehyde and aldehyde dehydrogenase will convert it into acetate.

• Which drugs can affect this metabolism and what are the effects thereof?

Disulfiram, Metronidazole, Cephalosporins and Hypoglycaemic drugs.

These drugs inhibit enzyme aldehyde dehydrogenase which converts acetaldehyde into acetate. The accumulation of acetaldehyde cause symptoms such as nausea, headache, dizzy etc. The feeling in general is not pleasant and in general these drugs are used in people who has a high tolerance for alcohol.