Responses to cardiovascular drugs during alcohol withdrawal.
OBJECTIVE
To present findings on the kinetics and dynamics of cardiovascular drugs during alcohol withdrawal (AW), compared with that observed in remission.


METHODS
Studies were reviewed and summarized.


RESULTS
A single-dose study in alcoholic patients with propranolol, a beta-adrenergic antagonist, showed that the negative inotropic effect was decreased and the bradycardiac effect increased during AW as compared with during early remission. The hypotensive effect of isosorbid dinitrate, commonly used as a vasodilatator, was weaker at the onset of AW, being associated with the decreased bioavailability of the drug. Verapamil, which is a L-type Ca2+ channel antagonist, produced a bradycardiac effect at the onset of AW, but no effect was observed in early remission. The effect was probably due to changes in L-type Ca2+ channels because no differences in verapamil concentrations between AW and early remission were observed.


CONCLUSIONS
Taken together, AW modifies the dynamics and kinetics of cardiac drugs, which may have an impact on the treatment of alcoholic patients with cardiac diseases.
Kähkönen
Seppo
S
BioMag Laboratory, Helsinki University Central Hospital; Cognitive Brain Research Unit, University of Helsinki, Finland. seppo.kahkonen@helsinki.fi
D000319:Adrenergic beta-Antagonists / Q000009:adverse effects / Q000627:therapeutic use*; D001682:Biological Availability; D001919:Bradycardia / Q000139:chemically induced; D002121:Calcium Channel Blockers / Q000009:adverse effects / Q000627:therapeutic use*; D000431:Ethanol / Q000009:adverse effects*; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007548:Isosorbide Dinitrate / Q000627:therapeutic use*; D008297:Male; D011433:Propranolol / Q000009:adverse effects / Q000627:therapeutic use*; D012074:Remission Induction; D013375:Substance Withdrawal Syndrome / Q000188:drug therapy* / Q000209:etiology*; D014665:Vasodilator Agents / Q000627:therapeutic use*; D014700:Verapamil / Q000009:adverse effects / Q000627:therapeutic use*
D000319:Adrenergic beta-Antagonists; D002121:Calcium Channel Blockers; D014665:Vasodilator Agents; D000431:Ethanol; D011433:Propranolol; D014700:Verapamil; D007548:Isosorbide Dinitrate