Ethanol toxicity: Difference between revisions
m (Rossdonaldson1 moved page Ethanol Toxicity to Ethanol toxicity) |
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##Lactic acidosis | ##Lactic acidosis | ||
##Epigastric pain (pancreatitis) | ##Epigastric pain (pancreatitis) | ||
==Differential Diagnosis== | |||
{{Sedatve/hypnotic toxicity types}} | |||
==Diagnosis== | ==Diagnosis== | ||
#Blood sugar | #Blood sugar | ||
#BAL | #BAL | ||
# | #*Appropriate if AMS is due to unknown cause | ||
# | #*Not necessarily required in mild-mod intoxication or if no other abnormality suspected | ||
#Elevated osmolar gap | #Elevated osmolar gap | ||
Revision as of 16:29, 12 March 2015
Background
- AMS that doesn't improve after few hrs is due to alternative cause until proven otherwise
- Blood Alcohol Level
- Correlates poorly with degree of intoxication
- Rate of ETOH elimination is 15-30mg/dL/hr (depending on degree of chronic alcoholism)
Clinical Features
- Classic Features
- Slurred speech
- Nystagmus
- Ataxia
- N/V
- Respiratory depression
- Coma
- Other Features (if malnourished)
- Hypoglycemia
- Ketoacidosis
- Lactic acidosis
- Epigastric pain (pancreatitis)
Differential Diagnosis
Sedative/hypnotic toxicity
- Absinthe
- Barbiturates
- Benzodiazepines
- Chloral hydrate
- Gamma hydroxybutyrate (GHB)
- Baclofen toxicity
- Opioids
- Toxic alcohols
- Xylazine toxicity
Diagnosis
- Blood sugar
- BAL
- Appropriate if AMS is due to unknown cause
- Not necessarily required in mild-mod intoxication or if no other abnormality suspected
- Elevated osmolar gap
Treatment
- GI decontamination
- Activated charcoal ineffective (ETOH is too rapidly absorbed)
- Hypoglycemia
- Give glucose immediately (do not have to wait to give thiamine first)
- "Banana Bag"
- IV form is not justified
- Likelihood of vitamin deficiency (except for thiamine) is low
- IVF does not hasten ETOH elimination
Disposition
- Most pts require observation only
- Can be discharged once patient at baseline mental status, able to tolerate PO, and road test successful
See Also
Source
- Tintinalli