Such interactions may be fatal, as alcohol is metabolised by the cytochrome P450 system, and other drugs which compete may have their clearance slowed down. Tolbutamide when taken with alcohol may produce a disulfiram-like reaction due to raised acetaldehyde levels. Pharmacy role The community pharmacist may be involved in the detection, management and prevention of alcohol misuse. A brief intervention may be beneficial if one suspects or has been approached by a patient regarding problem drinking. The CAGE screening questionnaire could also be used by community pharmacists under the right circumstances.
Pharmacists can work as part of the multi-disciplinary team caring for the patient.
They can monitor prescriptions for drug interactions and also be vigilant with purchases of OTC medicines containing small quantities of alcohol.