Acute alcohol intoxication can result from a high level of alcohol An alcoholic beverage is a drink containing ethanol . Alcoholic beverages are divided into three general classes: beers, wines, and spirits in the bloodstream The circulatory system is an organ system that passes nutrients , gases, hormones, blood cells, etc. to and from cells in the body to help fight diseases and help stabilize body temperature and pH to maintain homeostasis, accompanied by extreme drunkenness Alcohol intoxication is a physiological state occurring when an organism has a high level of ethanol in its bloodstream, or when ethanol otherwise causes the physiological effect known as drunkenness. In humans, common symptoms may include slurred speech, euphoria, impaired balance, poor coordination, flushed face, reddened eyes, reduced. The term acute alcohol intoxication is used by healthcare providers A health care provider or health professional is an organization or person who delivers proper health care in a systematic way professionally to any individual in need of health care services, often in emergencies. Toxicologists Toxicology is the study of the adverse effects of chemicals on living organisms. It is the study of symptoms, mechanisms, treatments and detection of poisoning, especially the poisoning of people also speak of alcohol intoxication to discriminate from other toxins A toxin is a poisonous substance produced by living cells or organisms (although humans are technically living organisms, man-made substances created by artificial processes usually are not considered toxins by this definition). It was the organic chemist Ludwig Brieger (1849-1919) who first used the term 'toxin' researched in the field.
Epidemiology
A drunken male on the ground, Pichilemu, Chile Chile (traditional English pronunciation /ˈtʃɪli/, also pronounced /ˈtʃiːleɪ/ ), officially the Republic of Chile (Spanish: República de Chile [reˈpuβlika ðe ˈtʃile] ( listen)), is a country in South America occupying a long, narrow coastal strip between the Andes mountains to the east and the Pacific Ocean to the west. It borders.The condition is frequently found in either young people who are being exposed to commonly available alcoholic beverages like beer, wine, and distilled liquor for the first time, and don't know their limits, or by people suffering from alcoholism who ingest much more than they usually do.
Pathophysiology
Ethanol is metabolised to acetaldehyde by ethanol dehydrogenase, which is found in many tissues, including the gastric mucosa. Acetaldehyde is metabolised to acetate by acetaldehyde dehydrogenase, which is predominantly found in liver mitochondria. However, it takes roughly 90 minutes for a healthy liver to metabolize a single ounce, approximately one hour per standard unit.
Ethanol's acute effects are largely due to its nature as a CNS depressant, and are dependent on blood alcohol concentrations:
- 20–99 mg/dL - Impaired co-ordination and euphoria Euphoria is medically recognized as a mental/emotional state defined as a profound sense of well-being. Some do not wish to admit that concepts such as 'euphoria' are essentially metaphysical. Technically, euphoria is an affect, but the term is often colloquially used to define emotion as an intense state of transcendent happiness combined with an
- 100-199 mg/dL - Ataxia Ataxia is a neurological sign and symptom that consists of gross lack of coordination of muscle movements. Ataxia is a non-specific clinical manifestation implying dysfunction of the parts of the nervous system that coordinate movement, such as the cerebellum. Several possible causes exist for these patterns of neurological dysfunction. The term &, poor judgement, labile mood
- 200-299 mg/dL - Marked ataxia, slurred speech, poor judgement, labile mood, nausea and vomiting
- 300-399 mg/dL - Stage 1 anaesthesia, memory lapse, labile mood
- 400+mg/dL - Respiratory failure, coma and death
As drinking increases, people become sleepy, or fall into a stupor Stupor is the lack of critical cognitive function and level of consciousness wherein a sufferer is almost entirely unresponsive and only responds to base stimuli such as pain. The word derives from the Latin stupure, meaning insensible. Being characterised by impairments of reactions to external stimuli, it usually appears in infectious diseases,. Ultimately, the respiratory system becomes depressed, and the person will stop breathing. This is a common cause of death on college campuses. The most important thing for friends who witness someone "passing out" from too much alcohol is to get them emergency medical treatment. Commonly, comatose patients aspirate their vomit (resulting in vomitus in the lungs, which may cause "drowning" and later pneumonia if survived). CNS depression and impaired motor co-ordination along with poor judgement increases the likelihood of accidental injury occurring. [1]. It is estimated that about half of alcohol related deaths are due to accidents (32%) or intentional injury (13.7%)[2].
In addition to respiratory failure and accidents caused by effects on the central nervous system, alcohol causes significant metabolic derangements. Hypoglycaemia occurs due to ethanol's inhibition of gluconeogenesis Gluconeogenesis is a metabolic pathway that results in the generation of glucose from non-carbohydrate carbon substrates such as lactate, glycerol, and glucogenic amino acids, especially in children, and may cause lactic acidosis Lactic acidosis is a physiological condition characterized by low pH in body tissues and blood accompanied by the buildup of lactate, and is considered a distinct form of metabolic acidosis. The condition typically occurs when cells receive too little oxygen (hypoxia), for example during vigorous exercise. In this situation, impaired cellular, ketoacidosis Ketoacidosis is a type of metabolic acidosis which is caused by high concentrations of ketone bodies, formed by the breakdown of fatty acids and the deamination of amino acids. The two common ketones produced in humans are acetoacetic acid and β-hydroxybutyrate and acute renal failure Renal failure or kidney failure is a situation in which the kidneys fail to function adequately. There are two forms: acute (acute kidney injury) and chronic (chronic kidney disease); either form may be due to a large number of other medical problems. Metabolic acidosis is compounded by respiratory failure. Patients may also present with hypothermia.
Avoidance of intoxication
Alcohol is metabolized Metabolism is the set of chemical reactions that happen in living organisms to maintain life. These processes allow organisms to grow and reproduce, maintain their structures, and respond to their environments. Metabolism is usually divided into two categories. Catabolism breaks down organic matter, for example to harvest energy in cellular by a normal liver The liver is a vital organ present in vertebrates and some other animals. It has a wide range of functions, including detoxification, protein synthesis, and production of biochemicals necessary for digestion. The liver is necessary for survival; there is currently no way to compensate for the absence of liver function at that rate of about one ounce (one "highball Highball is the name for a family of mixed drinks that are composed of an alcoholic base spirit and a larger proportion of a non-alcoholic mixer. Originally, the most common highball was made with Scotch whisky and carbonated water", a normal beer, a regular sized glass of wine) every 90 minutes. An "abnormal" liver, one with hepatitis Hepatitis is an inflammation of the liver characterized by the presence of inflammatory cells in the tissue of the organ. The name is from the Greek hepar (ἧπαρ), the root being hepat- (ἡπατ-), meaning liver, and suffix -itis, meaning "inflammation" (c. 1727). The condition can be self-limiting (healing on its own) or can, cirrhosis Cirrhosis is a consequence of chronic liver disease characterized by replacement of liver tissue by fibrosis, scar tissue and regenerative nodules (lumps that occur as a result of a process in which damaged tissue is regenerated), leading to loss of liver function. Cirrhosis is most commonly caused by alcoholism, hepatitis B and C, and fatty liver, gall bladder In vertebrates the gallbladder is a small organ that aids digestion and stores bile produced by the liver. In humans the loss of the gallbladder is usually easily tolerated disease, cancer Cancer /ˈkænsər/ (medical term: malignant neoplasm) is a class of diseases in which a group of cells display uncontrolled growth (division beyond the normal limits), invasion (intrusion on and destruction of adjacent tissues), and sometimes metastasis (spread to other locations in the body via lymph or blood). These three malignant properties, etc, will have a slower rate of metabolism. One can delay the absorption In vertebrates, the small intestine is the part of the gastrointestinal tract following the stomach and followed by the large intestine, and is where the vast majority of digestion and absorption of food takes place. In invertebrates such as worms, the terms "gastrointestinal tract" and "large intestine" are often used to of alcohol by drinking water and ingesting food, but it prolongs the un-metabolized alcohol in the body.
Diagnosis
In determining if someone is intoxicated it is necessary to observe their behavior while the subject is sober to establish a baseline, ruling out a preexisting condition A pre-existing condition is a risk with extant causes that is not readily compensated by standard, affordable insurance premiums. Preexisting condition exclusions by the insurance industry are meant to cope with adverse selection by potential customers. It has become a topic in the health care reform debate in the United States with a ban on such as hypoglycemia, usage of narcotics besides alcohol, mental health issues, etc. Several well known criteria can be used to establish a probable diagnosis. For a physician in the acute treatment setting, acute alcohol intoxication can mimic other acute neurological disorders, or is frequently combined with other recreational drugs Recreational drug use is drug use with the intention of creating or enhancing recreational experience. Such use is controversial, however, often being considered to be also drug abuse, and it is often illegal. Also, it may overlap with other uses, such as medicinal , performance enhancement, and entheogenic (spiritual) that complicate diagnosis and treatment. Definitive diagnosis Medical diagnosis refers both to the process of attempting to determine the identity of a possible disease or disorder and to the opinion reached by this process relies on a blood test for alcohol, usually performed as part of a toxicology Toxicology is the study of the adverse effects of chemicals on living organisms. It is the study of symptoms, mechanisms, treatments and detection of poisoning, especially the poisoning of people screen. Many patients are uninhibited, especially when legal consequences are unlikely (e.g., no police are present), so they disclose information that simplifies the diagnosis.
Treatment
Emergency treatment for acute alcohol intoxication strives to stabilize the patient and maintain a patent airway and respiration, while waiting for the alcohol to metabolize:[3] Also:
- Protect vital signs Vital signs are measures of various physiological statistics, often taken by health professionals, in order to assess the most basic body functions. Vital signs are an essential part of a case presentation. The act of taking vital signs normally entails recording Body temperature, Pulse rate , Blood pressure, and Respiratory rate, but may also by monitoring ABCs, or Airway, Breathing, and Circulation ABC and its variations are initialism mnemonics for essential steps used by both medical professionals and lay persons when dealing with a patient. In its original form it stands for Airway, Breathing and Circulation. The protocol was originally developed as a memory aid for rescuers performing cardiopulmonary resuscitation, and the most widely, ie., if the person is thought risk for severe respiratory depression, consider an Endotracheal tube An endotracheal tube is used in general anaesthesia, intensive care and emergency medicine for airway management, mechanical ventilation and as an alternative route for many drugs if an IV line cannot be established. The tube is inserted into a patient's trachea in order to ensure that the airway is not closed off and that air is able to reach the to protect the airway and assist with breathing.
- Protect the airway by aspirating stomach In some animals, including vertebrates, echinoderms, insects and molluscs, the stomach is a muscular, hollow, dilated part of the alimentary canal which functions as the primary organ of the digestive tract. It is involved in the second phase of digestion, following mastication (chewing). The stomach is located between the esophagus and the small contents that could cause aspiration pneumonia Aspiration pneumonia is bronchopneumonia that develops due to the entrance of foreign materials that enter the bronchial tree, usually oral or gastric contents . Depending on the acidity of the aspirate, a chemical pneumonitis can develop, and bacterial pathogens (particularly anaerobic bacteria) may add to the inflammation.
- Treat Hypoglycaemia Hypoglycemia or hypoglycaemia is the medical term for a pathologic state produced by a lower than normal level of blood glucose. The term hypoglycemia literally means "under-sweet blood" (low blood sugar) with 50ml of 50% dextrose solution and saline flush, as ethanol induced hypoglycaemia is unresponsive to glucagon.
- Administer the vitamin thiamine Thiamine or thiamin or vitamin B1 , and named as the "thio-vitamine" ("sulfur-containing vitamin") is a water-soluble vitamin of the B complex. First named aneurin for the detrimental neurological effects of its lack in the diet, it was eventually assigned the generic descriptor name vitamin B1. Its phosphate derivatives are, to prevent Wernicke-Korsakoff syndrome Wernicke-Korsakoff syndrome is a manifestation of thiamine (vitamin B1) deficiency, or beriberi. This is usually secondary to alcohol abuse. It mainly causes vision changes, ataxia and impaired memory, which can cause a seizure An epileptic seizure, occasionally referred to as a fit, is defined as a transient symptom of "abnormal excessive or synchronous neuronal activity in the brain". The outward effect can be as dramatic as a wild thrashing movement or as mild as a brief loss of awareness. It can manifest as an alteration in mental state, tonic or clonic (more usually a treatment for chronic alcoholism, but in the acute context usually co-administered to ensure maximal benefit).
- Check urea and electrolytes to guide fluid replacement.
- Apply Haemodialysis In medicine, hemodialysis is a method for removing waste products such as creatinine and urea, as well as free water from the blood when the kidneys are in renal failure. Hemodialysis is one of three renal replacement therapies (the other two being renal transplant; peritoneal dialysis) if the blood concentration is dangerously high (>400 mg%), and especially if there is metabolic acidosis.
Additional medication Medicine is the science and art of healing. It encompasses a range of health care practices evolved to maintain and restore health by the prevention and treatment of illness. Before scientific medicine, healing arts were practised in accordance with alchemical treatments and ritual practices that developed out of religious and cultural traditions may be indicated for treatment of nausea Nausea , is a sensation of unease and discomfort in the upper stomach with an urge to vomit. An attack of nausea is known as a qualm, tremor A tremor is an involuntary, somewhat rhythmic, muscle contraction and relaxation involving to-and-fro movements of one or more body parts. It is the most common of all involuntary movements and can affect the hands, arms, eyes, face, head, vocal cords, trunk, and legs. Most tremors occur in the hands. In some people, tremor is a symptom of another, and anxiety Anxiety is a psychological and physiological state characterized by cognitive, somatic, emotional, and behavioral components. These components combine to create an unpleasant feeling that is typically associated with uneasiness, apprehension, fear, or worry. Anxiety is a generalized mood condition that can often occur without an identifiable.
Prognosis
A normal liver detoxifies the blood of alcohol over a time that depends on the initial level and the patient's overall physical condition. An abnormal liver takes longer but still succeeds, as long as the alcohol doesn't cause liver failure Liver failure is the inability of the liver to perform its normal synthetic and metabolic function as part of normal physiology. Two forms are recognised:. [4]
People who have been drinking heavily for several days or weeks may have withdrawal Alcohol withdrawal syndrome is the set of symptoms seen when an individual reduces or stops alcohol consumption after prolonged periods of excessive alcohol intake. Excessive abuse of alcohol leads to tolerance, physical dependence, and an alcohol withdrawal syndrome. The withdrawal syndrome is largely due to the central nervous system being in a symptoms after the acute intoxication has subsided. [5]
References
- ^ McArdle, P (2004). Substance abuse by children and young people. Arch. Dis. Child. 89: 701-704
- ^ The World Health Organisation (2007) Alcohol and Injury in Emergency Departments
- ^ Devi, G., Castro, V. J., Huitink, J., Buitelaar, D., Kosten, T., O'Connor, P. (2003). Management of Drug and Alcohol Withdrawal. NEJM 349: 405-407
- ^ Management of alcoholic hepatitis, Drug and Therapeutics Bulletin 2003;41:49-52; doi:10.1136/dtb.2003.41749
- ^ DeBellis, R., Smith, B. S., Choi, S., Malloy, M. (2005). Management of Delirium Tremens. J Intensive Care Med 20: 164-173
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Categories: Alcohol abuse | Drinking culture | Intoxication
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Thu, 01 Jul 2010 05:12:49 GMT+00:00
thejournal-news.net Dr. Bowman stated that the level was enough to cause death by acute alcohol intoxication . She also stated due to the extent of the thermal injuries, ...
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4 Figure 4 Presence of narcotic substances in violent deaths not caused by acute intoxication A= Alcohol B= Alcohol + Others C= Morphine D= Morphine + Others E= Others Figure 5 Number of deaths subjected to chemical and toxicological tests
Smart Partyer
Fri, 16 Jul 2010 07:23:00 GM
He was held for observation because he was so heavily . intoxicated. . "I doubt that even he knows how much he drank," Tompkins said of the man. Blood . alcohol. levels of 0.40 or higher are generally toxic, Police Capt. ...
Q. I have often wondered why one's sex drive tends to be extremely intensified the morning/day/evening after a waking up from a night of alcohol consumption. I know that there are many others that experience this same situation. There MUST be some chemical processes going on internally or some medical explanation besides, "It's just a state of mind" or "You're just a horny M.F." I mean, I can see the connection of wanting to release endorphins to make the headache go away, but this doesn't completely explain the constant erections and the overwhelming sexual thoughts and acute sensitivity (at least for us men). Can anyone apply some real logic to this phenomenon? Is it the same for females too? Alright, I finally found a little article… [cont.]
Asked by T - Sun Sep 6 21:17:14 2009 - - 2 Answers - 0 Comments
A. true. I heard a radio show, Dr. Dean, with this same question. He really had no answer except that when you are hung over of course you dont like loud noises or fast movements and your love making experience can be improved by this because you and your partner are focused more on each other than outside stimuli. If you are not having sex the next day you might just be thinking about all the strange you should have got ;)
Answered by E T - Sun Sep 6 21:33:32 2009
