Summary
The chlorpropamide-alcohol flush (CPAF) phenomenon was quantitatively related to blood levels of acetaldehyde and chlorpropamide in 105 Type II diabetics, of whom 74 had not previously taken the drug and 31 were on chronic treatment. Standardized skin temperature recordings were made with a sensitive probe. Plasma ethanol and acetaldehyde concentrations were determined by gas chromatography, and those of chlorpropamide by high-pressure liquid chromatography. There were significant positive correlations between plasma acetaldehyde and the skin temperature increase, between plasma chlorpropamide and plasma acetaldehyde, and between plasma chlorpropamide and the skin temperature increase. CPAF-positive patients became CPAF-negative and vice versa following reduction and increase, respectively, in the dose of chlorpropamide. Thus, the CPAF reaction is a consequence of chlorpropamide inhibition of the oxidation of ethanol-generated acetaldehyde, and it appears that the plasma concentration of chlorpropamide is critical. It remains an open question whether the CPAF test has any prognostic value.
Similar content being viewed by others
References
Leslie RDG, Pyke DA (1978) Chlorpropamide-alcohol flushing: a dominantly inherited trait associated with diabetes. Br Med J 2: 1519–1521
Leslie RDG, Barnett AH, Pyke DA (1979) Diabetic retinopathy and chlorpropamide alcohol flushing. Lancet 1: 997–999
Barnett AH, Pyke DA (1980) Chlorpropamide-alcohol flushing and large-vessel disease in non-insulin-dependent diabetes. Br Med J 1: 261–262
Jerntorp P, Almér L-O (1981) Chlorpropamide-alcohol flushing in relation to macro-angiopathy and peripheral neuropathy in non-insulin dependent diabetes. Acta Med Scand [Suppl] 656: 33–36
Barnett AH, Leslie RDG, Pyke DA (1981) Chlorpropamide-alcohol flushing and proteinuria in non-insulin-dependent diabetics. Br Med J 1: 522–523
Köbberling J, Bengsch N, Brüggeboes B, Schwarck H, Tillil H, Weber M (1980) The chlorpropamide alcohol flush — lack of specificity for familial non-insulin dependent diabetes. Diabetologia 19: 359–363
De Silva NE, Tunbridge WMG, Alberti KGMM (1981) Low incidence of chlorpropamide-alcohol flushing in diet-treated, non-insulin-dependent diabetes. Lancet 1: 128–131
Jerntorp P, Almér L-O, Melander A (1981) Is the blood chlorpropamide critical in chlorpropamide alcohol flush? Lancet 1: 165–166
Podgainy H, Bressler R (1968) Biochemical basis of the sulfonylurea-induced Antabuse syndrome. Diabetes 17: 679–683
Jerntorp P, Öhlin H, Bergström B, Almér L-O (1981) Increase in plasma acetaldehyde; an objective indicator of the chlorpropamide alcohol flush. Diabetes 30: 788–791
Wåhlin-Boll E, Melander A (1979) High-performance liquid chromatographic determination of glipizide and some other sulfonylurea drugs in serum. J Chromatogr 164: 541–546
Stowell AR (1979) An improved method for the determination of acetaldehyde in human blood with minimal ethanol interference. Clin Chim Acta 98: 201–205
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Jerntorp, P., Almér, L.O., Öhlin, H. et al. Plasma chlorpropamide: A critical factor in chlorpropamide-alcohol flush. Eur J Clin Pharmacol 24, 237–242 (1983). https://doi.org/10.1007/BF00613824
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00613824