Figure 352

Blood alcohol concentration (mg/dL) after the consumption of various amounts of alcohol (for an adult of about 150 lb).

tance in the metabolism of ethanol in humans, it may be involved in some of the reported interactions between ethanol and other drugs that are also metabolized by this system. Microsomal mixed-function oxidases may be induced by chronic ethanol ingestion. Because ethanol is metabolized in the liver, it can interfere with the metabolism of other drugs by blocking microsomal hydroxylation and demethylation. Drug classes whose metabolism is most affected include the barbiturates, coumarins, and anticonvulsants, such as phenytoin. Liver damage resulting from chronic abuse of ethanol can impair metabolism of a variety of drugs.

Normally, 90 to 98% of an ingested dose of ethanol is metabolized by the liver. Most of the remaining 2 to 10% is excreted unchanged in the urine and expired air. The ethanol content in the urine is normally about 130% of the blood concentration and is quite constant; the expired air contains about 0.05% of the blood ethanol level, a concentration that also is remarkably consistent.

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