ADME PROPERTIES OF ALCOHOL AND ITS IMPACT ON THE RESPIRATORY SYSTEM

Alcohol consumption is a globally prevalent behavior with well-established systemic health consequences. Its effects on the respiratory system remain under-recognized despite growing evidence of mechanistic and clinical significance. This review synthesizes the current understanding of alcohol’s pharmacokinetics, including absorption, distribution, metabolism, and excretion (ADME), as well as its role in mediating pulmonary dysfunction. Ethanol and related alcohols alter mucociliary clearance, compromise epithelial integrity, and suppress innate immune responses, enhancing the danger of respiratory infections, acute lung injury, and chronic pulmonary disease. Metabolic byproducts such as acetaldehyde and reactive oxygen species contribute to oxidative stress, mitochondrial damage, and pro-inflammatory cascades in the lung microenvironment. The review also highlights the synergistic impact of alcohol with other respiratory risk factors, including tobacco and environmental exposures. Clinical implications include underdiagnosed alcohol-related respiratory impairment, worse outcomes in critical care settings, and the need for targeted screening. Key research gaps are identified, including the lack of longitudinal studies, limited translational models, and underutilization of precision medicine frameworks. Future directions emphasize the importance of integrative, genotype-informed research to inform prevention and personalized management strategies. Addressing alcohol’s impact on respiratory health is essential to mitigating preventable disease burden worldwide.