title: Effect of ethanol in Paclitaxel injections on the ethanol concentration in exhaled breath.
abstract: BACKGROUND
  Ethanol is included in certain injectable preparations of anticancer drugs to increase their solubility. Since the volume of ethanol in these preparations is approximately half of the total injection volume, the potential inhibitory effects of ethanol on the central nervous system cannot be disregarded, especially considering that patients may drive immediately after administration of the medication. Therefore, the concentration of ethanol was examined in exhaled breath after administration of paclitaxel, an anticancer medication containing ethanol.
  
  
  METHODS
  The ethanol concentration in exhaled breath immediately after an intravenous infusion of paclitaxel was measured in 30 patients, using a balloon-type gas detector tube. Correlations between the concentration of ethanol in exhaled breath and the total amount of ethanol administered or the intravenous infusion speed were calculated.
  
  
  RESULTS
  The mean ethanol concentration in exhaled breath was 0.028 ± 0.015 mg/L. The correlation between the ethanol concentration in exhaled breath and the total dose of ethanol was weak (R2 = 0.25; p = 0.055), while the intravenous infusion speed showed a stronger positive correlation with the concentration of ethanol in the breath (R2 = 0.49; p = 0.11). The maximum concentration of ethanol measured in exhaled breath (0.06 mg/L) was equivalent to 40% of the threshold for drunk driving, as specified in the Road Traffic Act in Japan.
  
  
  CONCLUSIONS
  In this study, no patient had a breath ethanol concentration exceeding the legal threshold for drunk driving. However, it is still advisable for patients to avoid driving after receiving paclitaxel injections. When driving cannot be avoided, patients should wait for a sufficient time after receiving the injection before driving.
authors.affiliation: Center for Medical Education, Gunma University Graduate School of Medicine, Maebashi, Japan.
authors.forename: Tohru
authors.initials: T
authors.lastname: Aomori
authors.forename: Hironori
authors.initials: H
authors.lastname: Makino
authors.forename: Masayuki
authors.initials: M
authors.lastname: Sekizuka
authors.forename: Tadahiro
authors.initials: T
authors.lastname: Hashita
authors.forename: Takuya
authors.initials: T
authors.lastname: Araki
authors.forename: Keiko
authors.initials: K
authors.lastname: Iizuka
authors.forename: Tomonori
authors.initials: T
authors.lastname: Nakamura
authors.forename: Koujirou
authors.initials: K
authors.lastname: Yamamoto
mesh_terms: D000328:Adult; D000368:Aged; D000972:Antineoplastic Agents, Phytogenic / Q000008:administration & dosage* / Q000493:pharmacokinetics*; D001944:Breath Tests; D000431:Ethanol / Q000008:administration & dosage* / Q000493:pharmacokinetics*; D045853:Exhalation; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy* / Q000378:metabolism*; D017239:Paclitaxel / Q000008:administration & dosage*
chemical_list: D000972:Antineoplastic Agents, Phytogenic; D000431:Ethanol; D017239:Paclitaxel