DANGEROUS INTERACTIONS WITH OTHER DRUGS
Sedatives
Clearly the most dangerous drugs to mix with
alcohol are other sedatives, or "downers," such as
phenobarbital and pentobarbital. The depressing effects of alcohol on
brain function combined with the effects of the barbiturates can cause extreme impairment,
unconsciousness, or even death. One
of the most famous cases in medical ethics was that of a young woman, Karen Ann Quinlan, who drank alcohol in
combination with Quaaludes (methaqualone—a powerful sedative drug) and went
into a coma from which she never
recovered. This tragic case gained national attention because it raised the issue of whether a person should be removed from life-support machines after it
becomes clear that he or she will
never recover from a vegetative state.
Although few people
take alcohol-sedative combinations severe enough to cause coma or death, the
combination of even relatively low doses of alcohol and sedatives can be dangerous, powerfully impairing the ability to think clearly, make good decisions, or drive a
car. A person who is normally able
to perform these tasks perfectly well at the end of an evening after having had three or four beers over the
course of several hours might find that he is totally unable to perform them if
even a small dose of sedatives is added to the mix. The effects of the alcohol
may be totally unexpected in the
presence of the other sedative drug.
Antianxiety
Medications
Antianxiety medications, such as Valium, Librium,
and so forth, fall into the general
category called benzodiazepines and are used to treat anxiety, sleep disturbances, and seizures. They are also
used to treat alcohol-withdrawal
symptoms in detoxification clinics, These drugs are sedating and may cause severe drowsiness in the presence of
alcohol, increasing the risk of
household and automobile accidents.
Antibiotics
In combination with
acute doses of alcohol, some antibiotics can cause nausea, vomiting, headache, or even convulsions
(seizures). Among the potentially
dangerous ones are Furoxone (furazolidone), Grisactin (griseofulvin), Flagyl (metronidazole), and Atabrine
(quinacrine).
Anticoagulants
(Blood Thinners)
Warfarin (Coumadin) is prescribed to decrease the
blood's ability to clot.
Alcohol increases the availability of
warfarin in the body and increases
the risk of dangerous bleeding. But in chronic drinkers, warfarin's action
is decreased,
lessening these patients' protection from the consequences of blood-clotting disorders.
Antidepressants
Many people who are depressed use alcohol, and many alcoholics are also depressed. So, it is quite common for people to use alcohol with
antidepressant drugs. Alcohol
increases the sedative
effects of the tricyclic antidepressants
such as Elavil (amitriptyline). This impairs both mental and physical skills such as those necessary for
driving. Chronic drinking appears to
increase the action of some tricyclic antidepressants and decrease the action of others. Anyone who is on
antidepressants should
consult
closely with her doctor about how her medication reacts with alcohol.
Ant/diabetic Medications
Orinase (tolbutamide)
is given orally to help lower blood sugar in diabetic patients. Acute alcohol drinking prolongs the action of this
drug, and chronic drinking decreases
its availability in the body. Alcohol can also cause nausea and headache when
taken with some drugs of this class.
Antihistamines
Antihistamines such as
Benadryl (diphenhydramine) are available without a prescription and are used to treat allergic symptoms and
sometimes insomnia. They have
sedative effects that may be intensified by alcohol, increasing the probability of accidents. In older
persons these drugs can
cause
excessive dizziness and sedation, and their combination with alcohol may be particularly dangerous.
Ant/psychotic Medications
Drugs such as Thorazine (chlorpromazine) are used
to treat psychotic symptoms such as
delusions and hallucinations. Acute alcohol drinking can increase the sedative
effects of these drugs, resulting in impaired coordination and potentially fatal suppression of breathing.
Antiseizure Medications
One of the most widely used drugs prescribed to
treat epilepsy (seizures) is Dilantin (phenytoin). Acute alcohol drinking
increases the availability of Dilantin
in the body and increases the probability of side effects. Chronic drinking may decrease the availability of
Dilantin, dangerously hampering its
effectiveness and increasing the patient's risk of seizures.
Heart Medications
There are many
medications used to treat disease of the heart or circulatory system. Acute alcohol drinking can interact
with some of these to cause dizziness
or fainting upon standing up. These drugs include the angina medicine nitroglycerin and the blood
pressure medication Apresoline. In
addition, chronic alcohol drinking reduces the effectiveness of the blood
pressure medication Inderal (propranoloh.
Narcotic Pain Relievers
These drugs (e.g.,
morphine, Darvon, codeine, Demerol) are prescribed for moderate to severe pain, such as after surgery or
dental work. The combination of any
of these drugs with alcohol magnifies the sedative effects of both, increasing
the risk of death from overdose. This is one of the most common drug combinations to cause accidental
overdose deaths.
Nonnarcotic Pain Relievers
Some nonprescription
pain relievers such as aspirin, Advil, and Aleve can cause stomach bleeding and prevent the blood from
clotting normally Alcohol can worsen these side effects. In addition, aspirin
may increase the availability of
alcohol within the body, thereby increasing the intoxicating effect of a given drink. As we stated
before, the combination of Tylenol
(acetaminophen) and alcohol can result in the formation of chemicals that can cause liver damage. This can occur
even when the pain reliever is used in
recommended doses and even if it is taken after drinking
as a treatment for hangover.
CYNTHIA KUHN
CYNTHIA KUHN
