Possible Interaction: Ethanol and Enflurane

“Defluorination of enflurane in vivo can be inhibited or stimulated following treatment with ethanol , depending on the level of ethanol present when the enflurane is administered.”

“Therefore, whenever xenobiotics that are … chlorzoxazone, paracetamol (acetaminophen), halothane, enflurane , methoxyflurane, sevoflurane and many organic solvents (e.g. … an individual who is also chronically consuming ethanol , the accelerated metabolism of these agents and their clinical impact (e.g. …) and toxicological impact (accumulation of active metabolites) have to be considered.”

“Although ethanol (25–200 mm) had no effect on its own in this receptor, it was able to inhibit reversibly the enhancing effect of enflurane , toluene, and chloroform in a concentration-dependent manner.”

“This effect is more expressed when ethanol and enflurane are applied together.”

“ EF administration to rats treated chronically with ethanol caused significant elevations in plasma levels of aspartate and alanine aminotransferases and glutamate dehydrogenase, indicative of hepatic injury, whereas concurrent treatment of naive rats with EF and ethanol failed to produce the same effect.”

“Liver microsomes from rats fed ethanol (36% of total calories for 14 days) oxidized 1 mM EF (measured by its defluorination) at rates nearly 10-fold greater than those from control rats, reflecting the markedly enhanced content of immunoreactive microsomal P450IIE1 in the former animals.”

“Our results imply that ethanol-inducible P450IIE1 is the primary catalyst of hepatic EF bioactivation and that the increased bioactivation occurring in vivo secondary to chronic ethanol consumption is attendant with an increased incidence of EF hepatotoxicity.”

“In rats, isoniazid and ethanol enhance metabolism of enflurane and also induce a form of cytochrome P450 which is homologous with a form of rabbit liver cytochrome P450 known as 3a.”

“Halothane and enflurane both caused dose dependent inhibition of ethanol metabolism (15-40%) in all hepatocytes without exogenous addition of pyruvate.”