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ethanol intoxication
Etiology:
- binge drinking
Epidemiology:
- ethanol is most commonly involved in alcohol intoxication
- ethanol, alone or in combination with benzodiazepines, is responsible for more toxic overdoses than any other agent
- an average of 6 people die of ethanol poisoning each day in the U.S.
- 76% of ethanol poisoning deaths are among adults ages 35-64
- 3 stages during which the brain undergoes substantial changes may be particularly sensitive to neurotoxic effects of alcohol
- prenatal period, ages 15-19, age > 65 years [2]
- 76% of those who die from ethanol poisoning are men
Pathology:
- very high levels of blood alcohol can inhibit brainstem control of respiration & heart rate, & hypothalamic control of body temperature, resulting in death
Clinical manifestations:
1) behavioral, psychomotor & cognitive changes occur at levels as low as 20-30 mg/dL (1-2 drinks)
2) CNS depression
- narcosis or deep sleep is induced in many people at 160 mg/dL
3) death can occur at serum levels of 300-400 mg/dL
Laboratory:
- no anion gap [3]
- osmolal gap > 10 mOsm/kg H2O [3]
- blood alcohol of 80 mg/dL (0.08%) is legal level of ethanol intoxication
Management:
- normal saline, thiamine 100 mg, glucose
- supportive care [3]
- naloxone for acute ethanol intoxication (respiratory depression) [4]
Interactions
disease interactions
Related
alcohol abuse (includes alcohol use disorder, risky alcohol use)
alcoholic beverage
General
alcohol toxicity
References
- Centers for Disease Control and Prevention (CDC)
Alcohol Poisoning Deaths.
http://www.cdc.gov/vitalsigns/alcohol-poisoning-deaths/index.html
- Mewton L et al
Lifetime perspective on alcohol and brain health
BMJ 2020;371:m4691
PMID: 33272963
https://www.bmj.com/content/371/bmj.m4691
- Medical Knowledge Self Assessment Program (MKSAP) 19
Board Basics. An Enhancement to MKSAP19.
American College of Physicians, Philadelphia 2022
- NEJM Knowledge+ Question of the Weeks. Dec 11, 2018
https://knowledgeplus.nejm.org/question-of-week/4142/