Ethanol metabolism in heavy drinkers after massive and moderate alcohol intake

Keiding, Susanne; Christensen, Niels Juel; Damgaard, S.; Dejgåd, Anders; Iversen, Henning L.; Jacobsen, Anny; Johansen, Søren; Lundquist, Frank; Rubinstein, Elisabeth; Winkler, K.

doi:10.1016/0006-2952(83)90255-1

Cited by 57 publications

(33 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Others have found average alcohol elimination rates of 0.21 g kg −1 h −1 (SD, 0.05 g kg −1 h −1 ) in a multi-center study with alcoholics during detoxification [12]. Interestingly, the enhanced capacity to metabolize alcohol is not retained indefinitely, and after a period of abstinence, the elimination rate of ethanol returns to values expected for moderate drinking, namely, 0.15 g l −1 h −1 [30]. In-vitro studies demonstrate a rapid turnover in the microsomal CYP2E1 enzyme after the absence of substrate [10,41].…”

Section: Discussionmentioning

confidence: 96%

“…Prolonged heavy drinking also leads to dispositional or metabolic tolerance, which can account for the faster rate of metabolism and give a steeper slope in the post-peak BAC elimination phase [28,49]. The mechanism underlying this ultra-rapid metabolism of ethanol is generally thought to involve an induction of the CYP2E1 enzymes [22,30,54].…”

Section: Discussionmentioning

confidence: 99%

“…The CYP2E1 enzyme has a higher k m for oxidation of ethanol (0.5-0.6 g/l) and, therefore, plays a more important role in metabolism of ethanol after heavy drinking, as what occurs in many drunk drivers [33,40]. Moreover, studies have shown that the activity of CYP2E1 increases appreciably after a period of continuous heavy drinking as a consequence of enzyme induction (increased synthesis), which leads to a faster oxidation of substrates [5,21,30]. However, the dose of alcohol and the duration of drinking necessary to boost the activity of CYP2E1 in humans have never been determined empirically [2,48].…”

Section: Introductionmentioning

confidence: 98%

See 2 more Smart Citations

Ultra-rapid rate of ethanol elimination from blood in drunken drivers with extremely high blood-alcohol concentrations

Jones

2007

Int J Legal Med

View full text Add to dashboard Cite

The rate of alcohol elimination from blood was determined in drunken drivers by taking two blood samples about 1 h apart. These cases were selected because the individuals concerned had reached an extremely high blood-alcohol concentration (BAC) when they were apprehended. This suggests a period of continuous heavy drinking leading to the development of metabolic tolerance. Use of double blood samples to calculate the elimination rate of alcohol from blood is valid provided that drunken drivers are in the post-absorptive phase of the BAC curve, the time between sampling is not too short, and that zero-order elimination kinetics operates. Evidence in support of this came from other drunken drivers in which three consecutive blood samples were obtained at hourly intervals. The mean BAC (N = 21) was 4.05 g/l (range, 2.71-5.18 g/l), and the average rate of alcohol elimination from blood was 0.33 g l(-1) h(-1) with a range of 0.20-0.62 g l(-1) h(-1). The possibility of ultra-rapid rates of ethanol elimination from blood in drunken drivers having extremely high BAC deserves to be considered in forensic casework, e.g., when retrograde extrapolations and other blood-alcohol calculations are made. The mechanism accounting for more rapid metabolism is probably related to induction of the microsomal enzyme (CYP2E1) pathway for ethanol oxidation, as one consequence of continuous heavy drinking. However, the dose of alcohol and the duration of drinking necessary to boost the activity of CYP2E1 enzymes in humans have not been established.

show abstract

Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 98%

See 1 more Smart Citation

Ultra-rapid rate of ethanol elimination from blood in drunken drivers with extremely high blood-alcohol concentrations

Jones

2007

Int J Legal Med

View full text Add to dashboard Cite

show abstract

“…Further, if the vascular alterations in cirrhosis are associated with the hyperdynamic circulatory state, an impaired gas exchange in the pulmonary vasculature could be partly responsible for a hypoxemic condition, although no alterations in pulmonary vascular channels were noted in our study. In alcoholics, blood ethanol clearance is accelerated by the so-called metabolic tolerance, so that alcohol induces a greater increase in oxygen consumption in alcoholics than in nondrinking subjects (18,19).…”

Section: Discussionmentioning

confidence: 99%

Development of Hypoxemia in Alcoholic Liver Disease

et al. 2005

View full text Add to dashboard Cite

The aim of this study was to investigate the arterial hypoxemia in Japanese patients with alcoholic liver disease (ALD) with regard to alcohol consumption and/or disease severity. Hypoxemia was observed in 78% patients with ALD and in all 46 patients with alcoholic liver cirrhosis (ALC) and 33 (56%) of 59 patients with noncirrhotic alcoholic liver disease (NCALD) (P < 0.0001). The partial pressure of oxygen (PaO2) was 71.1 +/- 5.2 mm Hg in ALC and 78.7 +/- 6.3 mm Hg in NCALD (P < 0.0001). The oxygen consumption in ALD was significantly higher than that in control subjects (P < 0.0001), and a high oxygen consumption was seen in 88% of the patients with ALD, in all 46 ALC patients, and in 46 (78%) of 59 NCALD patients (P < 0.01). Following abstinence from alcohol, the PaO2 and oxygen consumption significantly recovered after day 2 (P < 0.0001), whereas the prothrombin index did not change in either NCALD or ALC patients. Multivariate analysis showed that alcohol consumption and oxygen consumption were significant independent predictors of PaO2. In conclusion, the present findings suggest that increased oxygen consumption due to alcohol ingestion is principally responsible for the hypoxemia in ALD patients.

show abstract

“…An interesting feature of CYP2E1 is that after a period of continuous heavy drinking the activity of the enzyme increases, a process known as enzyme induction (Oneta et al 2002). It is this mechanism that is offered to explain the faster elimination rates of ethanol (0.25-0.35 g/L per hour) seen in alcoholics during detoxification (Keiding et al 1983). …”

Section: Pharmacokinetics Of Ethanolmentioning

confidence: 99%