Alcohols (medicine)

This article is about use of alcohols in medicine. For ethanol as a psychoactive drug, see Alcohol (drug). For other uses, see Ethanol.

Alcohol

Ethanol is a commonly used medical alcohol.

Clinical data
Drug class| Antiseptics, disinfectants, antidotes
Routes of
use| Topical, intravenous, by mouth
Defined daily dose| Not established[1]
Legal
Legal status|

* US: OTC

Pharmacokinetics
Metabolism| Liver

Alcohols, in various forms, are used within medicine as an antiseptic, disinfectant, and antidote.[2] Alcohols applied to the skin are used to disinfect skin before a needle stick and before surgery.[3] They may be used both to disinfect the skin of the person and the hands of the healthcare providers.[3] They can also be used to clean other areas[3] and in mouthwashes.[4][5][6] Taken by mouth or injected into a vein, ethanol is used to treat methanol or ethylene glycol toxicity when fomepizole is not available.[2]

Side effects of alcohols applied to the skin include skin irritation.[3] Care should be taken with electrocautery, as ethanol is flammable.[2] Types of alcohol used include ethanol, denatured ethanol, 1-propanol, and isopropyl alcohol.[7][8] Alcohols are effective against a range of microorganisms, though they do not inactivate spores.[8] Concentrations of 60 to 90% work best.[8]

Alcohol has been used as an antiseptic as early as 1363, with evidence to support its use becoming available in the late 1800s.[9] It is on the World Health Organization's List of Essential Medicines.[10] The wholesale cost in the developing world is about US$1.80–9.50 per litre of 70% denatured ethanol.[11] In the United Kingdom, it costs the NHS about 3.90 GBP per liter of 99% denatured alcohol.[2] Commercial formulations of alcohol based hand rub or with other agents such as chlorhexidine are available.[8][12]

## Contents

* 1 Medical uses
* 1.1 Methanol poisoning
* 1.2 Dosage
* 2 Mechanism
* 3 History
* 4 Society and culture
* 4.1 Cost
* 5 References
* 6 External links

## Medical uses[edit | edit source]

Applied to the skin, alcohols are used to disinfect skin before a needle stick and before surgery.[3] They may be used both to disinfect the skin of the person and the hands of the healthcare providers.[3] They can also be used to clean other areas,[3] and in mouthwashes.[4] Taken by mouth or injected into a vein ethanol is used to treat methanol or ethylene glycol toxicity when fomepizole is not available.[2]

Aside from these uses, ethanol has no other well-accepted medical uses.[13] This is partly because the therapeutic index of ethanol is 10:1.[14]

### Methanol poisoning[edit | edit source]

Taken by mouth or injected into a vein ethanol is used to treat methanol or ethylene glycol toxicity when fomepizole is not available.[2]

### Dosage[edit | edit source]

The defined daily dose is not established[1]

## Mechanism[edit | edit source]

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.[15]

## History[edit | edit source]

Alcohol has been used as an antiseptic as early as 1363 with evidence to support its use becoming available in the late 1800s.[9] Since antiquity, prior to the development of modern agents, alcohol was used as a general anesthetic.[16]

## Society and culture[edit | edit source]

### Cost[edit | edit source]

The U.S. cost for isopropyl alcohol is about $11 for of 473 milliliters (0.47 liters)[17]

* Isopropyl alcohol costs (US)

* Isopropyl alcohol prescriptions (US)

## References[edit | edit source]

1. ↑ 1.0 1.1 "WHOCC - ATC/DDD Index". www.whocc.no. Archived from the original on 1 July 2021. Retrieved 14 September 2020.
2. ↑ 2.0 2.1 2.2 2.3 2.4 2.5 British national formulary : BNF 69 (69 ed.). British Medical Association. 2015. pp. 42, 838. ISBN 9780857111562.
3. ↑ 3.0 3.1 3.2 3.3 3.4 3.5 3.6 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.
4. ↑ 4.0 4.1 Hardy Limeback (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.
5. ↑ Moni Abraham Kuriakose (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.
6. ↑ Jameel RA, Khan SS, Kamaruddin MF, Abd Rahim ZH, Bakri MM, Abdul Razak FB (2014). "Is synthetic mouthwash the final choice to treat oral malodour?". Journal of the College of Physicians and Surgeons Pakistan. 24 (10): 757–62. doi:10.2004/JCPSP.757762 (inactive 29 January 2020). PMID 25327922.`{{cite journal}}`: CS1 maint: DOI inactive as of January 2020 (link)
7. ↑ "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.
8. ↑ 8.0 8.1 8.2 8.3 McDonnell G, Russell AD (January 1999). "Antiseptics and disinfectants: activity, action, and resistance". Clin. Microbiol. Rev. 12 (1): 147–79. doi:10.1128/cmr.12.1.147. PMC 88911. PMID 9880479.
9. ↑ 9.0 9.1 Block, Seymour Stanton (2001). Disinfection, Sterilization, and Preservation. Lippincott Williams & Wilkins. p. 14\. ISBN 9780683307405. Archived from the original on 13 January 2017.
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. ↑ "Alcohol, Denatured". International Drug Price Indicator Guide. Archived from the original on 15 July 2020. Retrieved 8 December 2016.
12. ↑ Bolon MK (September 2016). "Hand Hygiene: An Update". Infect. Dis. Clin. North Am. 30 (3): 591–607. doi:10.1016/j.idc.2016.04.007. PMID 27515139.
13. ↑ Pohorecky LA, Brick J (1988). "Pharmacology of ethanol". Pharmacol. Ther. 36 (2–3): 335–427. doi:10.1016/0163-7258(88)90109-x. PMID 3279433.
14. ↑ Becker DE (2007). "Drug therapy in dental practice: general principles. Part 2 - pharmacodynamic considerations". Anesth Prog. 54 (1): 19–23, quiz 24–5. doi:10.2344/0003-3006(2007)54[19:DTIDPG]2.0.CO;2. PMC 1821133. PMID 17352523.
15. ↑ Barceloux DG, Bond GR, Krenzelok EP, Cooper H, Vale JA (2002). "American Academy of Clinical Toxicology practice guidelines on the treatment of methanol poisoning". J. Toxicol. Clin. Toxicol. 40 (4): 415–46. doi:10.1081/CLT-120006745. PMID 12216995.
16. ↑ Edmond I Eger II; Lawrence J. Saidman; Rod N. Westhorpe (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.
17. ↑ "Isopropyl alcohol topical Prices, Coupons & Patient Assistance Programs". Drugs.com. Archived from the original on 27 August 2021. Retrieved 28 February 2021.

## External links[edit | edit source]

Identifiers:|

* ATC code:

* D08AX08 (WHO) V03AB16 (WHO), V03AZ01 (WHO)

* CAS Number: 64-17-5
* PubChem CID: 702
* DrugBank:

* DB00898

* ChemSpider:

* 682

* UNII:

* 3K9958V90M

|

* v
* t
* e

Antiseptics and disinfectants (D08)

Acridine derivatives|

* Ethacridine lactate
* 9-Aminoacridine
* Euflavine

Biguanides and amidines|

* Dibrompropamidine
* Chlorhexidine#
* Propamidine
* Hexamidine
* Polihexanide

Phenol and derivatives|

* Hexachlorophene
* Policresulen
* Phenol
* Triclosan
* Triclocarban
* Chloroxylenol#
* Biphenylol
* Fenticlor

Nitrofuran derivatives|

* Nitrofurazone

Iodine products|

* Iodine/octylphenoxypolyglycolether
* Povidone-iodine#
* Diiodohydroxypropane

Quinoline derivatives|

* Dequalinium
* Chlorquinaldol
* Oxyquinoline
* Clioquinol

Quaternary ammonium compounds|

* Benzalkonium
* Benzethonium chloride
* Cetrimonium (bromide/chloride)
* Cetylpyridinium
* Cetrimide
* Benzoxonium chloride
* Didecyldimethylammonium chloride

Mercurial products|

* Mercuric amidochloride
* Phenylmercuric borate
* Mercuric chloride
* Merbromin
* Thiomersal
* Mercuric iodide

Silver compounds|

* Silver nitrate

Alcohols|

* Propanol (propyl alcohol)
* Isopropanol (isopropyl alcohol)
* Ethanol (ethyl alcohol)#

Other|

* Potassium permanganate
* Sodium hypochlorite
* Halazone
* Monalazone
* Hydrogen peroxide
* Eosin
* Chloramine-T (tosylchloramide)
* Octenidine dihydrochloride

* #WHO-EM
* ‡Withdrawn from market
* Clinical trials:
* †Phase III
* §Never to phase III

*[US]: United States
*[CID]: Compound ID
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*[t]: Discuss this template
*[e]: Edit this template