Ethanol is eliminated primarily by a saturable (Michaelis-Menten) process[8] BMN 673 cell line Hence, the half-life of ethanol changes according to the dose or the rate of administration. Paclitaxel injections contain 50% (v/v) ethanol; thus, if 300 mg of paclitaxel is injected, 25 mL ethanol

is also administered. This amount is equivalent to 500 mL of beer or 60 mL of whisky. Furthermore, because the first-pass effect does not apply to intravenous infusions, the effects of ethanol will be greater than with oral administration. In this study, an ethanol concentration in exhaled breath that exceeded the threshold for drunk driving, as specified in the Road Traffic Act, was not detected in any patient, but there was Dabrafenib mw one case that reached more than 40% of the threshold. Moreover, a previous report described several cases that exceeded the threshold defined by the law[9] The relationship between the ethanol concentration in breath and that in blood has been investigated, and a method of deducing the blood concentration from the concentration in breath has been established. Moreover, when considering the CNS effects, the ethanol concentration in breath (which reflects the arterial blood ethanol concentration) is considered to be a more suitable indicator than the venous blood ethanol concentration. The ratio of venous blood ethanol concentrations to exhaled breath ethanol concentrations

is approximately 2000 : 1[7] The average blood ethanol concentration estimated from our findings was 0.06 ± 0.03 mg/mL. Webster et al. reported that the average plasma ethanol concentration after administration of paclitaxel in Caucasian patients was 0.07 ± 0.10 mg/mL[6] When the average doses of paclitaxel in both studies (155 ± 76 and 293 ± 35 mg, respectively) are taken into consideration, the estimated blood ethanol concentrations may have been a little higher in our study. The difference in the

body size between Japanese and Caucasian subjects may have affected this. Because ethanol has a fast elimination PAK6 rate, its concentrations steady state rapidly, and this is why the plasma ethanol concentration at the end of administration depends on the infusion speed. Thus, the ethanol concentration in exhaled breath after administration of paclitaxel is considered to be affected by the infusion speed but not by the total amount of ethanol administered. There were several subjects who complained of facial flush or light-headedness after the end of the intravenous infusion, which may have been a response to the ethanol metabolite, acetaldehyde[10] In these cases, markers other than the breath ethanol concentration should be considered, in order to assess the degree of intoxication. In general, patients with high sensitivity to ethanol tend to present with symptoms of alcohol impairment and also have impaired decision-making ability.