Difference between revisions of "Ethanol toxicity"
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| Line 6: | Line 6: | ||
==Clinical Features== | ==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== | ==Differential Diagnosis== | ||
| Line 23: | Line 23: | ||
==Diagnosis== | ==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== | ==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== | ==Disposition== | ||
| Line 48: | Line 48: | ||
*[[Beer Potomania Syndrome]] | *[[Beer Potomania Syndrome]] | ||
| − | == | + | ==References== |
| − | |||
[[Category:Tox]] | [[Category:Tox]] | ||
Revision as of 12:57, 1 June 2015
Contents
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)
- Opioids
- Toxic alcohols
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