Ethanol

Ethanol is a topic covered in the Washington Manual of Medical Therapeutics.

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General Principles

Pathophysiology

  • Ethanol enhances inhibitory signaling through the GABA-A receptor and suppresses excitatory signaling through the NMDA glutamate receptor.
  • Over time, patients with chronic heavy ethanol use will develop profound tolerance to the effects of ethanol.
    • This occurs via qualitative changes in GABA-A receptors which render them less sensitive to activation, and via quantitative upregulation of NMDA receptors.
  • Ethanol is eliminated primarily by the alcohol dehydrogenase pathway; elimination follows zero-order kinetics.
  • Acute and chronic heavy ethanol use have many deleterious health effects that are outside the scope of this chapter (e.g., alcoholic hepatitis, pancreatitis, cardiomyopathy, peptic ulcer disease, cancers).

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General Principles

Pathophysiology

  • Ethanol enhances inhibitory signaling through the GABA-A receptor and suppresses excitatory signaling through the NMDA glutamate receptor.
  • Over time, patients with chronic heavy ethanol use will develop profound tolerance to the effects of ethanol.
    • This occurs via qualitative changes in GABA-A receptors which render them less sensitive to activation, and via quantitative upregulation of NMDA receptors.
  • Ethanol is eliminated primarily by the alcohol dehydrogenase pathway; elimination follows zero-order kinetics.
  • Acute and chronic heavy ethanol use have many deleterious health effects that are outside the scope of this chapter (e.g., alcoholic hepatitis, pancreatitis, cardiomyopathy, peptic ulcer disease, cancers).

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