Naked Science Forum
Life Sciences => Physiology & Medicine => Topic started by: MaryP on 27/04/2004 18:43:10
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Wonder if any one out there can give me some advice relating to the taking of medication and the changes that it may have on the breath, blood alcohol test.
The police recently stopped my husband on the way to work and breathalysed him; this was some 5 hours after his last drink, which was 3 glasses of wine with an evening meal.
On waking up for work my husband took 6 * 5mg Prednisolone tablets which were prescribed only 2 days previous for a skin complaint that he has developed since packing in cigarettes.
Along with this he rubbed an amount of eumovate eczema & dermatitis cream in the worst effected areas, also suffering from a severe toothache he took 3 panadol tablets.
Having set of he placed a NiQuitin CQ lozenge in his mouth to stop the craving for a cigarette, once the police stopped him for a routine check he reacted totally out of character for him by becoming most aggressive and rude to the police, this led them to believe that he had been drinking as they were shocked at his reaction to just being pulled for a routine check.
The breath test proved positive so therefore he was taken to the police station where he was given a lion intoxilyzer test which returned a reading of 50mg / 100ml, he was then given the option of a blood sample be taken for analysis, which having calmed down by then he duly agreed to.
What I would like to know is if any of these drugs would/could have had an effect on the absorption and dispercence of the alcohol into his bloodstream.
Having now read the known side effects from some of these drugs then I would say without doubt that my husbands aggressive reaction was down to these drugs, but I am also concerned that his over the legal breath test limit reading may also be attributed to these drugs as another side effect can be water/fluid retention.
While this may sound a very poor lame excuse for yet another case of someone over the limit trying to worm out of it, this is not the case at all as my husband has no idea I am even enquiring about this.
But would really like some answers as to whether or not this cocktail of drugs made any difference to him being over the limit.
With Respect
Mary P
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You are quite correct that high doses of steroids (specifically glucocorticoids like prednisolone) can provoke uncharacteristic behavioural change including aggression and depression. However, these agents do not affect blood alcohol levels which are determined by the rate at which the liver metabolises alcohol, and (to a lesser extent) the amount that is passed in urine.
You say your husband woke up with a headache - was it a hangover ? Are you sure he drank only 3 glasses of wine ?
However, in the history you give, you say that your husband has been itchy. Is he jaundiced (yellow, particularly the whites of the eyes) ? Liver problems can occasionally make you itchy. Has he ever had any liver diseases ? Has his liver function been checked by a doctor recently ? If, for some reason, he has a liver problem he may not have been clearing alcohol from the blood stream as rapidly as normal. An unlikely possiblity, but worth looking into.
Chris
"I never forget a face, but in your case I'll make an exception"
- Groucho Marx
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Thank you for your response, Chris I am sure of the levels of alcohol that my husband consumed as this was a meal in the house, although it was a red wine based sauce, which we had. Your referral to the amount of wine consumed sounds as if the reading is higher than what would be expected for that amount of alcohol.
As I was present all the time I know this to be true along with the fact my husband has not had a drop of alcohol for some 6 weeks prior to this, as he started to gain weight having gave up the cigarettes he not being a heavy drinker decided to cut out alcohol until he sorted out his weight gain, but as the wine was open for cooking he did share a glass or so with myself.
With regards of the panadol taken then he assured me at the time that this was for a toothache and not a headache, he is having ongoing treatment for his teeth, although headaches on a regular basis is something which he does complain about, but he puts this down to tiredness.
Since quitting smoking my husbands health has been horrendous with numerous complaints most of which he chooses to ignore, but the itchy rash that I referred to was one complaint that he could not ignore because it was so uncomfortable, this rash has been present for some 8 weeks now and is all over his body, but at it’s worst around his eyes and upper body. The doctor thought it was a reaction to the nicotine patches that he started on so prescribed the nicotine lozenge instead but the rash just got worst, hence the steroids were prescribed.
The rash starts off as a reddening of the skin then the area in question dries out and the skin becomes all flaky and scaly like.
Although my husband does not look what I would say jaundiced from my experience of my children as babies having jaundice, most scars and old marks on his legs from football and the like have taken on a yellow colour, also he now bruises very easily, but another complaint that he has had for a number of weeks now is being constantly tired and he complained recently of being constipated for long periods, again something out of character for him.
One final point although this may sound like I said a worm out, nothing could be further from the truth as my husband has already handed in his notice for work as he’s going to lose his licence, although there is the slim hope of the blood test being negative, also he sits around in a daze all day, so I’m really concerned about his mental health, he is due to visit the doctor in a couple of days time but I know even if I mention this advice to him he will not do anything about it.
When he went along to the doctors for advice on quitting smoking the doctor informed him that it was 11 years since they last seen him so as you can imagine he is one of those who chooses to ignore health threats than have them checked out.
Would you think it would be possible for myself to speak to the doctor prior to his visit and ask the doctor to ask the type of questions that would be needed for him to have his liver checked out? Along with any other questions, that would get to the reasons behind his constant tiredness.
Thank you for taking the time out to reply to this post and not just choosing to ignore it as another case of regret after the incident.
With Respect
A concerned wife.
Mary P
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You can always call your doctor to chat about things. Whilst the doctor cannot reveal details of your husband's consultation (if you weren't there) it can sometimes be extremely helpful to hear additional information from friends or relatives which might be relevant to the case.
In relation to the mood disturbance this is very likely to be a combination of the shock and anxiety of what has happened, struggling to give us cigarettes and, above all, the steroids. Some people are sensitive to their effects and can manifest all kinds of mental disturbances ranging from depression to euphoria.
Chris
"I never forget a face, but in your case I'll make an exception"
- Groucho Marx
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MaryP - I'm not a medico nor a lawyer, but I want to chip in here and say DON'T GIVE UP! Don't let your husband give up. He should keep his job as long as possible (make them fire him!), and definitely go to court to try to convince the judge to let him keep his license. It sounds to me like you have a good case for "extenuating circumstances" that might let him keep his license and a normal life. If you want to call it a "worm out", so be it, but it's better than just rolling over.
You should go to the doctor with your husband so that you know what is said and you can ask questions also. I do this to my dad all the time. He was declining and wouldn't go to the doctor until he ended up in the hospital with congestive heart failure. He still told me nothing was wrong. Since then I've just pranced right into the doctor's office with him and made sure they both were on the same wavelength. It has really helped all the way around.
Good luck and best wishes to you and your husband!
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Reluctantly my husband has agreed, for me to go to the doctors with him on his next visit, also he seems a bit better today now that he has stopped taking the steroids.
Chris may I ask what kind of test would be needed to find out if my husbands liver is indeed not functioning properly, have still not to mention to him regarding my questions here as I would like a bit more information first, so as if/when there is any chance that the taking of the medication could have affected his blood alcohol levels I can convince him that it is worth pursuing this.
Like I mentioned in a previous post his general health has been bad since packing in the cigarettes, or is this just coincidental, as things like the tiredness, headaches, constipation and then the rash have been around for a while.
When I asked him regarding the headaches and tiredness and has he told the doctor his reply was “no it’s getting used to being a non smoker” which he attributes everything to, as he had smoked for some 30 years as many as 30 cigarettes a day.
Anyway will keep you posted as to how this pans out as it is great just to have someone to talk to about this matter, as up to know only my husband and a few work collegues know of this.
Thanks all
With Respect
Mary P
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Hello Mary
since your husband is non-specifically off-colour there would be little harm in doing a routine series of blood tests just to check that nothing is out of kilter. A normal blood screen would include red cell count (to exclude anaemia), U/E (urea and electrolytes - which should include calcium) and LFTs (liver function tests). I can't really guide you because it is very difficult to draw conclusions without seeing the patient, and nor would it be acceptable for me to interfere with you own doctor's management plan.
"I never forget a face, but in your case I'll make an exception"
- Groucho Marx
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Mary, it sounds like your husband is chronically dehydrated.
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Donnah
Could you elaborate on?
“it sounds like your husband is chronically dehydrated”
not sure of what you mean.
Chris I have read up some on the BBC medical site regarding LFT’s and one or two other blood tests that can be conducted without much hassle, all I need to do is convince my husband that this would be worthwhile, more so for his own health, than the drink related incident.
There is certainly a difference in my husband’s behaviour this last day or two since he’s stopped taking the steroids, he does not fly off the handle quite so quickly so hopefully this weekend I should get the chance to talk to him about getting help.
One other point can anyone explain the relevance of coming into contact with someone who has or has recently had chicken pox or shingles, whilst taking steroid tablets.
With Respect
Mary P
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Hi Mary,
Headaches, fatigue, rash and constipation CAN be symptoms of dehydration. The steroids may have caused him to excrete more fluid and electrolytes, making it difficult to maintain proper hydration.
Look to Chris for information regarding your husband's problems. My thought is that proper hydration could be a valuable adjunct to your husband's healing.
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Certain steroids actually have a mineralocorticoid effect meaning that they promote retention of salt and water and can cause hypertension. This is not usually an issue with short courses of steroids given for a specific complaint like a rash or exacerbation of asthma.
More frequently patients experience psychological disturbance include wakefulness at night, depression and other changes in temperament. These changes are usually transient and resolve with cessation of the offending agent. You can minimise the effect by taking the steroid early on in the day time, and never at night (unless you like being an insomniac).
Exposure to chickenpox or shingles is not a problem in someone who has had chickenpox before. There will usually be sufficient levels of circulating neutralising antibodies to prevent any problems.
Chris
"I never forget a face, but in your case I'll make an exception"
- Groucho Marx