:Alcohols (medicine)

95% ABV ethanol is known as spiritus fortis in medical context.

{{main|Alcohol septal ablation}}

Ablysinol (a brand of 99% ethanol medical alcohol) was sold from $1,300 to $10,000 per 10-pack{{Fix|text=Give volume amount please}} in 2020 due to FDA administrator action granting exclusivity when used for treating hypertrophic obstructive cardiomyopathy with alcohol septal ablation in the US through 2025, despite "misuse" of the orphan drug act.{{cite news | vauthors = Paavola A |title=Why price of dehydrated alcohol is going from $1,300 to $10K |url=https://www.beckershospitalreview.com/pharmacy/why-price-of-dehydrated-alcohol-is-going-from-1-300-to-10k.html |work=www.beckershospitalreview.com |date=12 February 2020 }}{{cite news |title=Biotech executives, having pledged fair pricing, criticize drugmaker for steep hike |url=https://www.biopharmadive.com/news/belcher-price-increase-biopharma-executive-criticism-letter/572547/ |work=BioPharma Dive}}{{cite web |title=Statement on Belcher Pharmaceuticals |url=https://www.linkedin.com/feed/update/urn:li:activity:6635900853532311553/ |website=linkedin |access-date=19 October 2023 }}{{Unreliable source?|date=October 2023}}

Ethanol is listed under Antiseptics, and Alcohol based hand rub under Disinfectants, on the World Health Organization's List of Essential Medicines.{{cite book | vauthors = ((World Health Organization)) | title = The selection and use of essential medicines 2023: web annex A: World Health Organization model list of essential medicines: 23rd list (2023) | year = 2023 | hdl = 10665/371090 | author-link = World Health Organization | publisher = World Health Organization | location = Geneva | id = WHO/MHP/HPS/EML/2023.02 | hdl-access=free }}

Applied to the skin, alcohols are used to disinfect skin before a needle stick and before surgery. They may be used both to disinfect the skin of the person and the hands of the healthcare providers. They can also be used to clean other areas, and in mouthwashes.

Both ethanol and isopropyl alcohol are common ingredients in topical antiseptics, including hand sanitizer.{{Cite web | work = Center for Drug Evaluation and Research (CDER) |date=2023-05-12 |title=Q&A for Consumers {{!}} Hand Sanitizers and COVID-19 |url=https://www.fda.gov/drugs/information-drug-class/qa-consumers-hand-sanitizers-and-covid-19 | publisher = U.S. Food and Drug Administration |language=en}}

Research indicates that alcohol used as pre-surgical antiseptic preparations for ear procedures may have some ototoxic properties.{{cite journal | vauthors = Singh S, Blakley B | title = Systematic review of ototoxic pre-surgical antiseptic preparations - what is the evidence? | journal = Journal of Otolaryngology - Head & Neck Surgery = le Journal d'Oto-Rhino-Laryngologie et de Chirurgie Cervico-Faciale | volume = 47 | issue = 1 | pages = 18 | date = March 2018 | pmid = 29490694 | pmc = 5831715 | doi = 10.1186/s40463-018-0265-z | doi-access = free }} In this regard, these alcohol preparations may be considered potential ototoxic medication.

When taken by mouth or injected into a vein ethanol is used to treat methanol or ethylene glycol toxicity{{cite journal | vauthors = Mégarbane B | title = Treatment of patients with ethylene glycol or methanol poisoning: focus on fomepizole | journal = Open Access Emergency Medicine | volume = 2 | pages = 67–75 | date = 2010-08-24 | pmid = 27147840 | pmc = 4806829 | doi = 10.2147/OAEM.S5346 | doi-access = free }} when fomepizole is not available.

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.{{cite journal | vauthors = Barceloux DG, Bond GR, Krenzelok EP, Cooper H, Vale JA | title = American Academy of Clinical Toxicology practice guidelines on the treatment of methanol poisoning | journal = Journal of Toxicology. Clinical Toxicology | volume = 40 | issue = 4 | pages = 415–446 | date = 2002 | pmid = 12216995 | doi = 10.1081/CLT-120006745 | s2cid = 26495651 }}

Alcohol can intensify the sedation caused by hypnotics/sedatives such as barbiturates, benzodiazepines, sedative antihistamines, opioids, nonbenzodiazepines/Z-drugs (such as zolpidem and zopiclone).{{cite journal|url=http://my.lecom.edu/library/internetresources/journal%20articles/Acute%20Care%20for%20Alcohol%20Intoxication.pdf|archive-url=https://web.archive.org/web/20101214113109/http://my.lecom.edu/library/internetresources/journal%20articles/Acute%20Care%20for%20Alcohol%20Intoxication.pdf|archive-date=14 December 2010|title=Acute care for alcohol intoxication|journal=Postgraduate Medicine Online| vauthors = Yost DA |volume=112|issue=6|year=2002|access-date=29 September 2007}}

In the Netherlands, pentobarbital is part of the standard protocol for physician-assisted suicide for self-administration by the patient.{{cite web | vauthors = Köhler W |date=23 November 2000 |title=Euthanica |url=http://retro.nrc.nl/W2/Lab/Profiel/Euthanasie/euthanatica.html |work=Euthanesia Dossier |publisher=NRC Webpagina's |language=nl}} It is given in liquid form, in a solution of sugar syrup and alcohol, containing 9 grams of pentobarbital. This is preceded by an antiemetic to prevent vomiting.{{cite web | vauthors = Köhler W |date=23 November 2000 |title=Euthanica |url=http://retro.nrc.nl/W2/Lab/Profiel/Euthanasie/euthanatica.html |work=Euthanesia Dossier |publisher=NRC Webpagina's |language=nl}}

Ethanol, often in high concentrations, is used to dissolve many water-insoluble medications and related compounds. Liquid preparations of pain medications, cough and cold medicines, and mouth washes, for example, may contain up to 25% ethanol{{Cite web | url = https://www.mssny.org/App_Themes/MSSNY/pdf/AlcoholContent.pdf | title = Alcohol Content in Common Preparations | publisher = Medical Society of the State of New York | access-date = October 8, 2019 | archive-date = 29 April 2021 | archive-url = https://web.archive.org/web/20210429232655/https://www.mssny.org/App_Themes/MSSNY/pdf/AlcoholContent.pdf | url-status = dead }} and may need to be avoided in individuals with adverse reactions to ethanol such as alcohol-induced respiratory reactions.{{cite journal | vauthors = Adams KE, Rans TS | title = Adverse reactions to alcohol and alcoholic beverages | journal = Annals of Allergy, Asthma & Immunology | volume = 111 | issue = 6 | pages = 439–445 | date = December 2013 | pmid = 24267355 | doi = 10.1016/j.anai.2013.09.016 }} Ethanol is present mainly as an antimicrobial preservative in over 700 liquid preparations of medicine including acetaminophen, iron supplements, ranitidine, furosemide, mannitol, phenobarbital, trimethoprim/sulfamethoxazole and over-the-counter cough medicine.{{cite journal | vauthors = Zuccotti GV, Fabiano V | title = Safety issues with ethanol as an excipient in drugs intended for pediatric use | journal = Expert Opinion on Drug Safety | volume = 10 | issue = 4 | pages = 499–502 | date = July 2011 | pmid = 21417862 | doi = 10.1517/14740338.2011.565328 | s2cid = 41876817 }}

Some medicinal solutions of ethanol are also known as tinctures.

Usually mouthwashes are antiseptic solutions intended to reduce the microbial load in the mouth, although other mouthwashes might be given for other reasons such as for their analgesic, anti-inflammatory or anti-fungal action. Also, alcohol is added to mouthwash not to destroy bacteria but to act as a carrier agent for essential active ingredients such as menthol, eucalyptol and thymol, which help to penetrate plaque.{{citation |title= Chemical composition of everyday products | vauthors = Toedt J, Koza D, Van Cleef-Toedt K |edition= illustrated |publisher= Greenwood Publishing Group |year= 2005 |isbn= 9780313325793 |pages= 48–49 |url= https://books.google.com/books?id=UnjD4aBm9ZcC&q=active+ingredients+mouthwash&pg=PA48}}

A 2020 systematic review and meta-analysis concluded that there is no definitive link between alcohol-based mouthwash use and the risk of oral cancer.{{cite journal | vauthors = Aceves Argemí R, González Navarro B, Ochoa García-Seisdedos P, Estrugo Devesa A, López-López J | title = Mouthwash With Alcohol and Oral Carcinogenesis: Systematic Review and Meta-analysis | journal = The Journal of Evidence-Based Dental Practice | volume = 20 | issue = 2 | pages = 101407 | date = June 2020 | pmid = 32473798 | doi = 10.1016/j.jebdp.2020.101407 }} This should not be confused with the fact that alcohol consumption at any quantity is a risk factor for alcohol and cancer such as cancers of the mouth, esophagus, pharynx and larynx.{{cite journal | vauthors = Gormley M, Creaney G, Schache A, Ingarfield K, Conway DI | title = Reviewing the epidemiology of head and neck cancer: definitions, trends and risk factors | journal = British Dental Journal | volume = 233 | issue = 9 | pages = 780–786 | date = November 2022 | pmid = 36369568 | pmc = 9652141 | doi = 10.1038/s41415-022-5166-x }}

Absolute ethanol is used as a sclerosant in sclerotherapy. Sclerotherapy has been used "in the treatment of simple pleural effusions, vascular malformations, lymphocytes and seromas."{{cite journal | vauthors = Episalla NC, Orra S, Black CK, Dekker PK, Kim KG, Cardella JT, Evans KK | title = Sclerotherapy as an alternative treatment for complex, refractory seromas | journal = Journal of Surgical Case Reports | volume = 2021 | issue = 8 | pages = rjab224 | date = August 2021 | pmid = 34447570 | pmc = 8384448 | doi = 10.1093/jscr/rjab224 | publisher = Oxford University Press }}

Ethchlorvynol, developed in the 1950s, was used to treat insomnia, but prescriptions for the drug had fallen significantly by 1990, as other hypnotics that were considered safer (i.e., less dangerous in overdose) became much more common. Also, ethchlorvynol is not compatible with intravenous injection like ethanol—serious injury (including the loss of limbs due to vascular injury) or death can occur when it is used in this manner.{{cite journal | vauthors = Glauser FL, Smith WR, Caldwell A, Hoshiko M, Dolan GS, Baer H, Olsher N | title = Ethchlorvynol (Placidyl)-induced pulmonary edema | journal = Annals of Internal Medicine | volume = 84 | issue = 1 | pages = 46–48 | date = January 1976 | pmid = 942681 | doi = 10.7326/0003-4819-84-1-46 }} It is no longer prescribed in the United States due to unavailability, but it is still available in some countries and would still be considered legal to possess and use with a valid prescription.

Drinking alcohol will not prevent or cure COVID-19,{{cite web |title=Myth busters |url=https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public/myth-busters |website=who.int |publisher=World Health Organization |language=en}} contrary to some claims.{{cite news | vauthors = Baumgarten A |title=10 common myths busted about coronavirus in North Dakota |url=https://www.thedickinsonpress.com/newsmd/coronavirus/5039782-10-common-myths-busted-about-coronavirus-in-North-Dakota |access-date=14 April 2020 |work=The Dickinson Press |language=en}}

{{main|List of unproven methods against COVID-19}}

Vodka was alleged to be an effective homemade hand sanitizer, or an ingredient in one. The company whose brand was alleged to be protective responded to the rumours by citing the US Centers for Disease Control and Prevention statement that hand sanitizers needed to be at least 60% alcohol to be effective, and stating that their product was only 40% alcohol.{{Cite web|url=https://www.10news.com/news/fact-or-fiction/fact-or-fiction-titos-vodka-can-be-used-in-hand-sanitizer|title=Fact or Fiction: Tito's Vodka can be used in hand sanitizer?|date=March 10, 2020|publisher=KGTV|access-date=April 9, 2020}}{{cite web |title=Coronavirus: Don't use vodka to sanitise hands |url=https://www.bbc.co.uk/news/business-51763775 |website=BBC News |date=6 March 2020}}{{medcn|date=April 2020}}

{{see also|Medicinal Liquor Prescriptions Act of 1933}}

Since antiquity, prior to the development of modern agents, alcohol was used as a general anesthetic.{{cite book| vauthors = Eger II EI, Saidman LJ, Westhorpe RN |title=The Wondrous Story of Anesthesia|url=https://books.google.com/books?id=H--3BAAAQBAJ&pg=PA4|date=14 September 2013|publisher=Springer Science & Business Media|isbn=978-1-4614-8441-7 |pages=4– |url-status=live|archive-url= https://web.archive.org/web/20170918190140/https://books.google.com/books?id=H--3BAAAQBAJ&pg=PA4| archive-date=18 September 2017}}

File:Parable of the Good Samaritan (detail) by Cornelis van Haarlem.jpg (1627) showing the Samaritan pouring oil and wine on the injured man's wounds]]

In the history of wound care, beer,{{cite journal | vauthors = Shah JB | title = The history of wound care | journal = The Journal of the American College of Certified Wound Specialists | volume = 3 | issue = 3 | pages = 65–66 | date = September 2011 | pmid = 24525756 | pmc = 3601883 | doi = 10.1016/j.jcws.2012.04.002 }} and wine,[https://www.christianity.com/bible/commentary/john-gill/luke/10 John Gill's Exposition of the Bible] Classic Bible Commentaries are recognized as substances used for healing wounds.

Alcohol has been used as an antiseptic as early as 1363, with evidence to support its use becoming available in the late 1800s.{{cite book| vauthors = Block SS |title=Disinfection, Sterilization, and Preservation|date=2001|publisher=Lippincott Williams & Wilkins |isbn=9780683307405 |page=14 |url=https://books.google.com/books?id=3f-kPJ17_TYC&pg=PA14 |language=en |url-status=live|archive-url= https://web.archive.org/web/20170113110342/https://books.google.ca/books?id=3f-kPJ17_TYC&pg=PA14|archive-date=13 January 2017}}

At times and places of poor public sanitation (such as medieval Europe), the consumption of alcoholic drinks was a way of avoiding water-borne diseases such as cholera.{{Cite web| vauthors = Dunn R |title=Strong Medicine: Drinking Wine and Beer Can Help Save You from Cholera, Montezuma s Revenge, E. Coli and Ulcers 1|url=https://blogs.scientificamerican.com/guest-blog/strong-medicine-drinking-wine-and-beer-can-help-save-you-from-cholera-montezumas-revenge-e-coli-and-ulcers1/|access-date=2021-06-27|website=Scientific American Blog Network|language=en}}

Early doctors recognized that ethanol was a risky anesthetic because it could lead to death from alcohol poisoning or vomit inhalation (pulmonary aspiration). This led to use of alternatives in antiquity, such as opium and cannabis, and later diethyl ether starting in the 1840s.Grattan, N. "Treatment of Uterine Haemorrhage". Provincial Medicine and Surgical Journal. Vol. 1, No. 6 (Nov. 7, 1840), p. 107. As safer options became available, ethanol was eventually phased out as a general anesthetic.

Methylpentynol, discovered 1913, prescribed for the treatment of insomnia, but its use was quickly phased out in response to newer drugs with far more favorable safety profiles.{{cite journal | vauthors = Hirsh HL, Orsinger WH | title = Methylparafynol--a new type hypnotic. Preliminary report on its therapeutic efficacy and toxicity | journal = American Practitioner and Digest of Treatment | volume = 3 | issue = 1 | pages = 23–26 | date = January 1952 | pmid = 14903452 }}{{cite journal | vauthors = Schaffarzick RW, Brown BJ | title = The anticonvulsant activity and toxicity of methylparafynol (dormison) and some other alcohols | journal = Science | volume = 116 | issue = 3024 | pages = 663–665 | date = December 1952 | pmid = 13028241 | doi = 10.1126/science.116.3024.663 | bibcode = 1952Sci...116..663S }}{{cite journal | vauthors = Herz A | title = [A new type of hypnotic; unsaturated tertiary carbinols; experimental studies on therapeutic use of 3-methyl-pentin-ol-3 (methylparafynol)] | journal = Arzneimittel-Forschung | volume = 4 | issue = 3 | pages = 198–199 | date = March 1954 | pmid = 13159700 }} The drug has been replaced by benzodiazepines and is no longer sold anywhere.{{cite book | vauthors = Hines RD | title = The Pursuit of Oblivion | date = 2002 | pages = 327 }}

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{{Reflist}}

{{alcohols}}

{{Ancient anaesthesia}}

{{Antiseptics and disinfectants}}

{{Sedatives}}

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Category:Alcohol dehydrogenase inhibitors

Category:Alcohols

Category:Antidotes

Category:Antiseptics

Category:Dentifrices

Category:Disinfectants

Category:Hepatotoxins

Category:Sedatives

Category:GABAA receptor positive allosteric modulators

Category:World Health Organization essential medicines

Category:Wikipedia medicine articles ready to translate