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I have a list of medications i am checking to see if they…

Customer Question
I have a list...

I have a list of medications i am checking to see if they would cause someones BAC to rise and stay elevated longer? If i list those could you let me know?

Doctor's Assistant: Is there an upcoming drug test scheduled? What kind of samples are being tested?

No test upcoming. i know a person that had some drink the night before work and stopped around 2 am. went to bed and woke up and went to work the next day. She was given a BAC that read .098 and that was 10 hours after her last drink. She has MS and take a multitude of medications.

Doctor's Assistant: Anything else in your medical history you think the doctor should know?

Has MS and take alot of different medicaitons.

Submitted: 5 months ago.Category: Pharmacy
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Answered in 3 hours by:
11/17/2017
Pharmacist: Shaun Dillavou, Pharmacist replied 5 months ago
Shaun Dillavou
Shaun Dillavou, Pharmacist
Category: Pharmacy
Satisfied Customers: 150
Experience: Doctor of Pharmacy with 15 years experience in multiple settings.
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Hello - My name is ***** ***** I am a pharmacist with over 15 years experience. Thank you for the question and using JustAnswer.

There are some medications that can cause your body to not metabolize alcohol normally. If you can provide me with a list of medications, I will be happy to go through them and let you know what types of interactions they have with alcohol.

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Customer reply replied 5 months ago
Tysabri, Benadryl, Topomax, Detrol, Dicyclomine, Paxil, Xanax, Oxybutnin Chloride. This is for my wife who was fired from work and is now being investigated by Texas education agency. She has MS and takes a lot of meds and never would have gone to work had she known her BAC was not 0.00. They did the first breathalyzer and it was .098 and ten mins later did a second and it was .09.
Pharmacist: Shaun Dillavou, Pharmacist replied 5 months ago

Thank you - Give me a few minutes as I want to thoroughly review these and provide you with as much information as possible.

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Pharmacist: Shaun Dillavou, Pharmacist replied 5 months ago

Thank you for being patient.

As a general statement, alcohol should be avoided in most of these medications, primarily due to the potential for increased impairment. Several of these drugs have similar side effects, including dizziness, drowsiness, light-headedness, etc. When taken together, and including alcohol, these side effects can be magnified (topiramate, tolterodine), Benadryl, Xanax, and oxybutynin are included in these).

Most of these are metabolized by the liver, which alcohol is as well. However alcohol is metabolized by a different method than these medications. It is possible that a medication can be metabolized by the same method as alcohol, and thereby slowing down the metabolism of one or the other (or both), and thereby prolonging the effects and presence in the body/blood.

Based on these medications and information, I do not see a reason any of these would have caused a delay in metabolizing the alcohol. Depending on the timeline (when was the last drink, when did she report to work, when were the breathalyzers taken), there may be some indications that warrant further medical attention.

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Customer reply replied 5 months ago
Her last drink was around 1:30 or 2 and the breathalyzer was taken at a PrimaCare around 10:00.
Pharmacist: Shaun Dillavou, Pharmacist replied 5 months ago

OK - Typically, a BAC of 0.10% or less should be undetectable after 8 hours or so, depending on the person. Based on this timeline, the BAC at 1:30-2:00 would have been around 0.20% which is enough to usually require assistance with simple tasks, cause nausea and vomiting, and possibly blacking out. This would also be consistent with having 6+ drinks (ending at 1:30 to 2:00), depending on other factors (such as weight).

So - If by 2:00 she had consumed 6+ drinks and was exhibiting these behaviors, it would be "normal" to still have a BAC of 0.09% by 10:00am the next morning (with slight impairment). Does this sound accurate or is any of this way off? If it is way off (only had 2 drinks, little/no impairment at 2:00am, etc.), then I would suspect there is more to it.

Again, with the medications she is taking, some of the symptoms may have been exacerbated, but the BAC should not have been impacted to a great extent if at all.

From a legal standpoint from my experience (I do not have a law background, this is just what I recall from experience with a patient), impairment as a result of a BAC of 0.09% is viewed as impairment, regardless of the factors impacting the BAC.

From a medical perspective, my recommendation at this point would be to review the above (how many drinks, did behavior as described above match the timeline, etc.) to determine if this matter needs to be discussed with her doctor. Again, if the description is way off, there may be other factors at work that may need more medical attention (liver issues for example).

Regarding the breathalyzer: It could be argued that a reasonable timeline was followed regarding the activities of the night before and the morning of (stopped at 2:00 and only had x number of drinks in order to be sure ready for work), and that medications may have played a role in behavior (but unlikely BAC). I am not sure how well this will help if seeking to be reinstated to her position or with the investigation though. Depending on the nature of the investigation, you may want to seek legal council also.

I hope this helps answer your question. I will be happy to provide more details or clarification if you need any. If you do, I am available to respond anytime today.

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