Materiały źródłowe

• #1 Alcohol Poisoning Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/16640-alcohol-poisoning

  If someone has alcohol poisoning, they may need lifesaving treatment right away. In a medical setting, healthcare professionals will use: […] IV fluids: Providers give intravenous (IV) fluids to treat dehydration. Fluids can also increase blood sugar levels if they’re low. […] Oxygen therapy: Providers can give oxygen using a nasal cannula (flexible tube clipped to your nose). They may put a small tube into your windpipe if you have trouble breathing (intubation). […] Stomach pumping: Using a tube, providers can clear your stomach of toxins. […] Blood filtration: If your kidneys can’t do their job, providers may start dialysis to filter alcohol from your blood. […] Someone with alcohol poisoning needs medical help in a hospital. You shouldn’t try to treat it at home or sleep it off. A major danger of alcohol poisoning is choking on your vomit, which can happen when you’re unconscious or sleeping. This can cause death.

• #2 Alcohol poisoning – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/alcohol-poisoning/diagnosis-treatment/drc-20354392

  Alcohol poisoning treatment usually involves supportive care while the body rids itself of the alcohol. This typically includes: […] People who accidentally consume methanol or isopropyl alcohol may need hemodialysis. This is a mechanical way of filtering waste and toxins from the blood. It can speed the removal of alcohol from the blood.

• #3 Alcohol poisoning – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/alcohol-poisoning/symptoms-causes/syc-20354386

  If you think that someone has alcohol poisoning, get medical attention right away. […] If you think that someone has alcohol poisoning, seek medical care right away. This is true even if you don’t see the usual signs. […] Call 911 or your local emergency number right away. Never assume the person will sleep off alcohol poisoning. […] Be prepared to give information. If you know the kind and amount of alcohol the person drank, and when, tell hospital or emergency staff. […] Don’t leave an unconscious person alone. Because alcohol poisoning affects the way the gag reflex works, someone with alcohol poisoning may vomit and choke and not be able to breathe. […] Help someone who is vomiting. Try to keep the person sitting up. If the person must lie down, turn the head to the side to help prevent choking. Try to keep the person awake. […] Ask about follow-up care for alcohol poisoning. Meeting with a health care provider, particularly an experienced chemical dependency counselor, can help prevent future binge drinking.

• #4 Alcohol Toxicity Treatment & Management: Prehospital Care, Emergency Department Care, Consultations

  https://emedicine.medscape.com/article/812411-treatment

  The prehospital care provider has several important tasks. The first is to search for any empty containers near the patient. The second is to obtain a blood sugar level on anyone who appears intoxicated. Local protocols and the skill level of the provider dictate additional prehospital care for patients with altered mental status. […] As with all emergency patients, initial treatment should focus on the airway, breathing, and circulation. Gastric decontamination is rarely necessary for any of the alcohols. An exception to this may be a patient who presents immediately after ingestion of a toxic alcohol in whom one might reasonably expect to be able to recover a significant amount of the toxin via aspiration through a nasogastric tube. […] Treatment of ethanol and isopropanol intoxication is largely supportive. Because of the hemorrhagic gastritis that can follow isopropanol ingestion, H2 blockade or proton pump inhibitors may be helpful. Hemodialysis, while effective, is rarely indicated, and should be used only in the setting of profound hemodynamic compromise.

• #5 Understanding the Dangers of Alcohol Overdose | National Institute on Alcohol Abuse and Alcoholism (NIAAA)

  https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/understanding-dangers-of-alcohol-overdose

  Know the danger signals, and if you suspect that someone has an alcohol overdose, call 911 for help immediately. […] While waiting for medical help to arrive: Be prepared to provide information to the responders, including the type and amount of alcohol the person drank, other drugs they took (if known), and any health information that you know about the person (such as current medications, allergies to medications, and any existing health conditions). […] Do not leave an intoxicated person alone because they are at risk of getting injured from falling or choking. Keep the person on the ground in a sitting or partially upright position rather than in a chair. […] Help a person who is vomiting. Have them lean forward to prevent choking. If a person is unconscious or lying down, roll them onto one side with an ear toward the ground to prevent choking.

• #6 The Effects of Alcohol Poisoning and How Long They Last

  https://rehabsuk.com/blog/the-effects-of-alcohol-poisoning-and-how-long-they-last/

  Alcohol poisoning occurs when a person consumes a dangerously high amount of alcohol in a short period. […] It’s important to be aware of your limits and drink responsibly to avoid the risk of alcohol poisoning. […] In the worst cases, alcohol poisoning can be fatal. […] While most people recover from alcohol poisoning with proper care, it is crucial to recognise the potential risks and act swiftly if symptoms are severe. […] Recognising the signs of alcohol poisoning is essential for prompt intervention. If you suspect someone has alcohol poisoning, immediately call emergency services at 999. […] When you suspect someone has alcohol poisoning, follow these steps: Stay with the individual to monitor their condition and provide assistance if needed. […] If awake, have them sit upright to aid breathing and prevent choking.

• #7 The Effects of Alcohol Poisoning and How Long They Last

  https://rehabsuk.com/blog/the-effects-of-alcohol-poisoning-and-how-long-they-last/

  Offer water to sip, avoiding caffeinated beverages that can cause dehydration. […] If the person is unconscious, put them in the recovery position to prevent choking on vomit. […] Ensure the person stays warm to prevent hypothermia. […] Do not allow them to consume more alcohol. […] Cold exposure can be dangerous; avoid it to prevent accidents. […] Do not try to induce vomiting, as it can lead to choking. […] To prevent alcohol poisoning, consider these tips: Drink in moderation, keeping track of your alcohol consumption. […] Stay hydrated by drinking water between alcoholic beverages. […] Switch between alcoholic and non-alcoholic beverages. […] Understand your tolerance and avoid binge drinking. […] Consume a meal before drinking to slow alcohol absorption. […] If you or a loved one struggle with excessive alcohol consumption, seek professional support. […] Remember, alcohol poisoning is a serious medical emergency. If you suspect someone has alcohol poisoning, call 999 immediately and follow the recommended steps while awaiting medical help. Your quick action could save a life.

• #8 7 proven hangover cures and first aid for alcohol poisoning

  https://onlinefirstaid.com/7-proven-hangover-cures-and-first-aid-for-alcohol-poisoning/?srsltid=AfmBOoq6H7WbCOzJRYYiFA9JHlTM8_X0Fc4HBDywsYg-Fj60t5pdX-kU

  Ensure you have the skills to look after someone who has collapsed following too much alcohol. It is vital that if someone is unconscious and unable to maintain their own airway, that you put them into the recovery position. […] When someone has consumed so much alcohol that they have collapsed, immediately check that they are breathing and then roll them into the recovery position. This will ensure their airway remains clear. If someone is drunk, it becomes harder for them to maintain their body temperature making them susceptible to hypothermia. If they are outside, bring them in. Alternatively, if you are unable to move them, insulate them from the ground and cover them with a coat or blanket. Keep checking they are breathing and that their airway remains clear, especially if they are vomiting.

• #9 Alcohol Poisoning Symptoms & First Aid | St John Ambulance

  https://www.sja.org.uk/get-advice/first-aid-advice/poisoning/alcohol-poisoning/

  When someone drinks too much alcohol they can suffer from alcohol poisoning. […] If you think someone has alcohol poisoning, reassure them and cover them with a coat or blanket to keep them warm. […] Place the casualty in the recovery position so that they do not choke on any vomit. […] Monitor their level of response until they recover or until a responsible adult can take over care.

• #10 Ethanol poisoning: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/002644.htm

  Ethanol poisoning is caused by drinking too much of the alcohol found in alcoholic beverages. […] This article is for information only. DO NOT use it to treat or manage an actual poison exposure. If you or someone you are with has an exposure, call the local emergency number (such as 911), or the local poison control center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States. […] If you can wake an adult who has had too much alcohol, move the person to a comfortable place to sleep off the effects. Make sure the person will not fall or get hurt. […] Place the person on their side in case they throw up (vomit). DO NOT make the person throw up unless told to do so by a health care professional or Poison Control.

• #11 Ethanol poisoning: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/002644.htm

  Check the person frequently to make sure their condition does not get worse. […] If the person is not alert (unconscious) or only somewhat alert (semi-conscious), emergency assistance may be needed. When in doubt, call for medical help. […] The health care provider will measure and monitor the person’s vital signs, including temperature, pulse, breathing rate, and blood pressure. The person may receive: […] Airway support, including oxygen, breathing tube through the mouth (intubation), and ventilator (breathing machine). […] Blood and urine tests including a blood ethanol level. […] Fluids through the vein (intravenous or IV). […] Medicines to treat symptoms. […] Survival over 24 hours past the drinking binge usually means the person will recover. A withdrawal syndrome may develop as alcohol levels in the blood drop, so the person should be observed and kept safe for at least another 24 hours.

• #12 Alcohol Poisoning: Symptoms, Causes, Complications, and Treatment

  https://www.webmd.com/mental-health/addiction/alcohol-poisoning-overview

  If youve drunk a dangerous amount of alcohol, doctors may „pump” your stomach. This keeps any leftover alcohol from getting into your bloodstream. […] At the hospital, they may also: […] Give you fluids through an IV […] Give you extra oxygen to help you breathe […] Flush your stomach of toxins […] Remove toxins from your blood.

• #13 Alcohol Intoxication: Acute, Symptoms, Treatments, Signs, and More

  https://www.healthline.com/health/alcohol-intoxication

  Treatment for alcohol intoxication involves supportive care while the body tries to process the alcohol. You must seek emergency medical treatment for a person whos showing symptoms of alcohol poisoning. Call 911 or your local emergency services. […] Emergency medical technicians will take the intoxicated person to the hospital. There, professionals will: carefully monitor vital signs, prevent breathing or choking problems with a breathing tube that opens the airways, give oxygen therapy, give intravenous (IV) fluids to prevent dehydration, give vitamins and glucose (sugar) to prevent complications, fit a catheter, which allows urine to drain into a bag, so they dont wet themselves, pump the stomach (gastric lavage) to minimize the bodys absorption of already ingested alcohol, give activated charcoal to further minimize the bodys absorption of alcohol.

• #14 Alcohol poisoning | Description, Symptoms, & Treatment | Britannica

  https://www.britannica.com/science/alcohol-poisoning

  Alcohol poisoning, serious medical condition that results from intentional or accidental consumption of alcohol, generally in large quantities over a short period of time. […] Left untreated, alcohol poisoning can lead to brain damage, coma, or death. […] Treatment for alcohol poisoning usually is an emergency situation and involves life-saving measures, including oxygen therapy, the administration of intravenous fluids and glucose, dialysis, and stomach pumping. […] Various analyses may be simultaneously or subsequently carried out, among them measuring BAC (either by Breathalyzer or by blood testing) and testing to assess liver function, heart function, and electrolyte balance.

• #15 Alcohol intoxication: Signs, symptoms, and treatment

  https://www.medicalnewstoday.com/articles/327202

  People cannot treat severe alcohol intoxication or alcohol poisoning at home. If anyone shows signs of severe intoxication, contact emergency services immediately. In the U.S., call 911. […] In the emergency room, a doctor will check their BAC and look for other signs of alcohol poisoning, such as a slow heart rate and low blood sugar and electrolyte levels. […] A healthcare professional will monitor the persons vital signs while they recover. The doctor or nurse may also: […] administer fluids intravenously with an IV to prevent dehydration […] administer vitamins and sugar to treat low blood sugar […] insert a breathing tube to open the airways and provide more oxygen to the body […] pump the stomach to rid the body of excess alcohol. […] A low level of alcohol intoxication causes mild symptoms, while severe intoxication, or alcohol poisoning, can be life threatening. It requires immediate medical attention. […] People can survive alcohol poisoning if they receive appropriate treatment. However, recovery sometimes takes several weeks or months.

• #16 Ethanol Toxicity – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK557381/

  Treatment for acute ethanol toxicity is mostly supportive. The first priority, as always, is airway protection. The main life-threatening complication of alcohol intoxication is respiratory depression. Although most patients who present for alcohol intoxication receive intravenous fluids, there is no solid evidence to support this. Alcohol does act as a diuretic; thus, most patients who receive intravenous fluids are in an attempt to treat dehydration. As mentioned above, checking a point of care glucose is important, as many patients with alcohol use disorder will have depleted glycogen stores, and treating hypoglycemia is important, especially before replenishing vitamins such as thiamine. Few studies have shown vitamin deficiencies in intoxicated patients; thus, the routine use of IV multivitamins should be considered on a case-to-case basis. In contrast, routine use of thiamine is recommended for patients with alcohol use disorder, especially in the setting of altered mental status. Detecting occult thiamine deficiency and Wernicke encephalopathy is difficult, and this condition has a high mortality. Thus, the cost/benefit analysis falls in favor of administering thiamine. Patients with alcohol use disorder may not benefit from IV fluids, and consideration must be made for alcoholic cardiomyopathy in this patient population before administering fluids. Some patients may become agitated or violent. In these situations, sedative substances may be required, including droperidol or haloperidol, keeping in mind the potential interaction between the drug and alcohol. Depending on the severity of the intoxication and complications such as Wernicke encephalopathy, alcoholic hepatitis, or dysrhythmias, patients may have to be admitted to the hospital for further treatment.

• #17 How To Treat Alcohol Poisoning: Signs, Treatment & Prevention

  https://www.palmerlakerecovery.com/alcohol-abuse-and-addiction/treat-alcohol-poisoning/

  Alcohol poisoning treatment may include life support machines that breathe for those who are not able to breathe for themselves. Medications can be given to reduce vomiting, and other treatments can be used to control internal bleeding. […] People typically try to treat alcohol poisoning at home because they are afraid of others finding out that they have been drinking. Treating alcohol poisoning at home increases the risk of death and is never advised. While others finding out about alcohol use could be embarrassing, this embarrassment pales in comparison to the distress that a death would cause. […] You should never treat alcohol poisoning by yourself always call 911 as soon as alcohol poisoning is suspected. […] Treatment for alcohol poisoning centers on stabilizing vital functions and preventing further damage. In a hospital setting, medical professionals may: Administer Oxygen: To help support breathing if it is dangerously slow or irregular. Provide IV Fluids: To combat dehydration and stabilize electrolyte imbalances. Monitor Heart Rate and Vital Signs: Continuous monitoring ensures that any sudden changes in vital functions are quickly addressed. Perform Blood Tests: To check alcohol levels, glucose levels and other potential drug interactions or metabolic disturbances. Intubate if Necessary: In severe cases, a breathing tube may be inserted to protect the airway and support respiration. Manage Complications: If the person develops seizures or cardiac irregularities, additional treatments will be provided accordingly.

• #18 Alcohol poisoning

  https://www.nhs.uk/conditions/alcohol-poisoning/

  Alcohol poisoning can happen when you drink alcohol quicker than your body can process it. It can make you seriously ill and you may need to go to hospital for treatment. […] You’ll need to go to hospital to be monitored if you have alcohol poisoning. It can cause serious complications, like liver and heart failure, which can be fatal. […] You may be given fluids, which may be given into your veins with a drip. You may also be given help with your breathing until the effects of the alcohol wear off.

• #19 Acute Alcohol Intoxication : Emergency Care BC

  https://emergencycarebc.ca/clinical_resource/clinical-summary/acute-alcohol-intoxication/

  Recommended Treatment: Treatment is primarily supportive for AAI. […] If patients present with severe intoxication (BAC > 0.2-0.3) and coma, they should have their airway carefully monitored and stabilization should be considered. […] Place the patient in the lateral safety position to prevent aspiration. […] Obtain IV access and administer fluids if the patient is dehydrated, hypotensive, or malnourished. […] Anyone at risk of a nutritional deficiency should be given thiamine 100mg before glucose as Wernicke’s encephalopathy onset may be accelerated otherwise. […] If patient is severely hypoglycemic, do not delay administration of dextrose to prepare for thiamine infusion. […] For patients that are presenting with coma secondary to AAI, dextrose and 100 mg thiamine should be administered.

• #20 Acute Alcohol Intoxication : Emergency Care BC

  https://emergencycarebc.ca/clinical_resource/clinical-summary/acute-alcohol-intoxication/

  Consider giving antidotes in the case of simultaneous drug use (e.g., naloxone for opioid use). […] Monitor for withdrawal symptoms: Increased hand tremor, Seizures, Agitation, Nausea / vomiting, Insomnia, Hallucinations, Autonomic hyperactivity. […] If there is a history of head trauma or mental status does not improve after examinations, obtain head CT scan. […] In cases of repeated vomiting, administer antiemetic drugs (e.g., metoclopramide). […] If patient is agitated, consider using sedatives such as haloperidol or benzodiazepines but carefully monitor due to synergistic effect that can lead to respiratory depression. […] Encourage patients to rest and hydrate. […] Consider referral for possible alcohol use disorder (see in-depth resources). […] Consider admitting patient if they present with coma or significant complications of ethanol intoxication.

• #21 Alcohol Toxicity Medication: Pharmacologic antidotes, B Vitamins

  https://emedicine.medscape.com/article/812411-medication

  Fomepizole (4-methylpyrizole, Antizol) has greater affinity for alcohol dehydrogenase than ethanol or methanol and has a considerably better safety profile than ethanol. Fomepizole has been approved by the US Food and Drug Administration (FDA) for ethylene glycol poisoning, but it is also useful for managing methanol poisoning. […] B vitamins (ie, folic acid, pyridoxine, thiamine) may be useful in selected cases to reduce the toxicity of alcohol metabolites. […] These agents prevent formation of toxic metabolites in methanol ingestions (not useful with isopropanol or ethanol ingestions). Therapy generally is maintained until methanol levels are less than 20 mg/dL. […] Fomepizole is an inhibitor of alcohol dehydrogenase. It is the drug of choice for ethylene glycol and methanol poisoning because of its ease of administration and better safety profile than ethanol. In contrast to ethanol, fomepizole levels do not require monitoring during therapy.

• #22 Alcohol Toxicity Medication: Pharmacologic antidotes, B Vitamins

  https://emedicine.medscape.com/article/812411-medication

  Begin fomepizole treatment immediately upon suspicion of methanol/ethylene glycol ingestion based on the patient’s history or anion gap metabolic acidosis, increased osmolar gap, oxalate crystals in the urine, or a documented serum methanol/ethylene glycol level. Adjust dosing during hemodialysis; see package insert. […] Folic acid should be administered for several days to enhance folate-dependent metabolism of formic acid to carbon dioxide and water. […] In ethylene glycol poisoning, thiamine and pyridoxine shunt metabolism of glyoxylic acid away from oxalate and favor the formation of less toxic metabolites. In patients with ethanol-related hypoglycemia, especially those who are malnourished or alcoholics, pretreatment with thiamine may be necessary.

• #23 How To Treat Alcohol Poisoning: Signs, Treatment & Prevention

  https://www.palmerlakerecovery.com/alcohol-abuse-and-addiction/treat-alcohol-poisoning/

  Gastric lavage, often referred to as stomach pumping, was once a common treatment in cases of drug or alcohol overdose. However, its use has become less frequent because research suggests it offers limited benefit if performed more than an hour after ingestion, and it also carries its own risks. In practice today: Stomach pumping may sometimes be used if the person has recently consumed a toxic amount of alcohol (within about an hour), and theres a risk of more alcohol being absorbed from the stomach. Activated charcoal is sometimes used to absorb certain drugs, but its not consistently effective for alcohol because alcohol is absorbed too rapidly into the bloodstream. The mainstay of treatment remains supportive measures, such as ensuring the persons airway is open, and that they remain hydrated and stable.

• #24 Alcohol Toxicity Treatment & Management: Prehospital Care, Emergency Department Care, Consultations

  https://emedicine.medscape.com/article/812411-treatment

  Fomepizole should be administered as a loading dose of 15 mg/kg. Subsequent doses should be at 10 mg/kg every 12 hours for 4 doses. […] Hemodialysis is frequently required in patients with significant methanol or ethylene glycol ingestions. […] A number of case reports suggest that hemodialysis should be considered in the treatment of severe alcohol intoxication with serum ethanol levels 450 mg/dL. […] Patients with ethanol intoxication can usually be observed until they are no longer clinically intoxicated and then discharged. […] Patients with significant ingestions of toxic alcohols require hospital admission in a closely monitored setting such as the intensive care unit. […] For patients with ethanol intoxication who appear to have issues with dependence or abuse, consider referral to an alcohol detoxification facility. […] Consult a nephrologist for any known or suspected cases of methanol or ethylene glycol intoxication to assist in the decision making for hemodialysis.

• #25 Alcohol poisoning: Symptoms, treatment, and causes

  https://www.medicalnewstoday.com/articles/215627

  Alcohol poisoning is a significant medical condition. It requires immediate treatment. […] If a person suspects someone has alcohol poisoning they should call an ambulance. They should follow the below advice until medical assistance arrives. […] In the hospital, depending on the patients BAC level and severity of signs and symptoms, staff may just monitor them until their alcohol levels gradually drop. However, depending on the severity of symptoms, other treatments may include: […] If the person who may sometimes be a child has unintentionally drunk methanol or isopropyl alcohol and has alcohol poisoning they may need dialysis to speed up the removal of toxins from their system. […] It is important to keep hydrated and avoid drinking any alcohol. […] Alcohol poisoning can cause the body to shut down vital functions. It is a medical emergency that requires immediate attention. Common symptoms include loss of motor function, loss of consciousness, and abnormal breathing.

• #26 Alcohol Toxicity and Withdrawal – Special Subjects – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/special-subjects/illicit-drugs-and-intoxicants/alcohol-toxicity-and-withdrawal

  Treatment of alcohol toxicity may include the following: […] For withdrawal, benzodiazepines and sometimes also phenobarbital or propofol. […] The first priority is ensuring an adequate airway; endotracheal intubation and mechanical ventilation are required for apnea or inadequate respirations. IV hydration is needed for hypotension or evidence of volume depletion but does not significantly enhance ethanol clearance. […] Patients with severe alcohol withdrawal or delirium tremens should be managed in an intensive care unit until these symptoms abate. Treatment may include IV thiamin to prevent Wernicke encephalopathy. […] Benzodiazepines are the mainstay of therapy. […] Diazepam, given 5 to 10 mg IV or orally hourly until sedation occurs, is a common initial intervention; lorazepam 1 to 2 mg IV or orally is an alternative.

• #27 Alcohol Toxicity and Withdrawal – Special Subjects – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/special-subjects/illicit-drugs-and-intoxicants/alcohol-toxicity-and-withdrawal

  Delirium tremens may be fatal and thus must be treated promptly with high-dose IV benzodiazepines, preferably in an intensive care unit. […] Severe drug-resistant DT can be treated with a continuous infusion of lorazepam, diazepam, midazolam, propofol, or dexmedetomidine, usually with concomitant mechanical ventilation.

• #28 Alcohol Toxicity Treatment & Management: Prehospital Care, Emergency Department Care, Consultations

  https://emedicine.medscape.com/article/812411-treatment

  Once either methanol or ethylene glycol intoxication are suspected, treatment should be initiated without delay. Fortunately, since both of those alcohols are metabolized by alcohol dehydrogenase, the treatment is the same, and determining which of them is responsible is not necessary before implementing treatment. […] The primary antidotal treatment of methanol or ethylene glycol involves blocking alcohol dehydrogenase. This enzyme can be inhibited by either ethanol or fomepizole. […] Toxic alcohol levels are frequently not immediately available. Thus, ideally, if methanol or ethylene glycol poisoning is suspected, the patient should receive a loading dose of fomepizole while the levels are being obtained. […] Inhibition of alcohol dehydrogenase with ethanol may be substituted for treatment with fomepizole, though studies have highlighted the greater safety of fomepizole as a treatment, when available.

• #29 Treatment of severe alcohol poisoning | Nefrología

  https://www.revistanefrologia.com/en-treatment-severe-alcohol-poisoning-articulo-X2013251408005341

  Treatment of severe alcohol poisoning […] Management of severe methanol poisoning includes administration of ethanol or fomepizole and early start of HD. […] Management of severe ethylene glycol poisoning includes administration of ethanol or fomepizole and early start of HD. […] Administration of ethanol or fomepizole to delay metabolism of alcohols, methanol and ethylene glycol, is an integral part of therapy. […] Ethanol has a 10 to 20-fold greater affinity for ADH as compared to other alcohols, and completely inhibits ADH at a serum concentration of 100 mg/dL. […] Fomepizole has approximately a 500 to 1,000-fold greater affinity for ADH as compared to ethanol and may completely inhibit the enzyme at a much lower serum concentration. […] Ethanol infusion and HD should be continued until the serum levels of the toxic are sufficiently low or have completely disappeared.

• #30 Alcohol Toxicity Treatment & Management: Prehospital Care, Emergency Department Care, Consultations

  https://emedicine.medscape.com/article/812411-treatment

  In methanol overdose, sodium bicarbonate should be administered liberally, with the goal being to completely reverse the acidosis. […] If ethanol is used as an antidote, the recommended target serum concentration is 100-150 mg/dL. […] A 5% or 10% ethanol solution can be made in the pharmacy. If giving ethanol, administer a loading dose of 600 mg/kg, followed by a drip of 66-154 mg/kg/h, with patients who have alcohol use disorder requiring doses at the higher end of the scale. Ethanol can be given either intravenously or orally. […] Ethanol infusions are not only labor intensive, but once the costs of the frequent blood glucose and serum ethanol level assays are accounted for, ethanol antidotal therapy is frequently more expensive than fomepizole. […] Thus, because of the lower overall cost and the ease of administration and safety considerations, fomepizole has become the preferred antidote for methanol or ethylene glycol poisoning.

• #31 Alcohol Toxicity Treatment & Management: Prehospital Care, Emergency Department Care, Consultations

  https://emedicine.medscape.com/article/812411-treatment

  In some patients, treatment with fomepizole alone may represent definitive treatment and can prevent the need for hemodialysis. […] In addition to blocking alcohol dehydrogenase, significant metabolic acidosis should be treated with sodium bicarbonate infusions. If methanol is suspected, folinic acid should be administered at a dose of 1 mg/kg, with a maximal dose of 50 mg. It should be repeated every 4 hours. If folinic acid is not immediately available, folic acid can be substituted at the same dose. […] If ethylene glycol overdose is suspected, the patient should also receive 100 mg of intravenous thiamine every 6 hours and 50 mg of pyridoxine every 6 hours. The purpose of the thiamine and pyridoxine is to shunt metabolism of glyoxylic acid away from oxalate and favor the formation of less toxic metabolites.

• #32 Toxic Alcohol Ingestion • LITFL • CCC Toxicology

  https://litfl.com/toxic-alcohol-ingestion/

  Gastrointestinal decontamination is not routinely recommended. […] Antidotal therapy with fomepizole or ethanol will inhibit ADH and prevent the formation of toxic metabolites in methanol and ethylene glycol poisoning. […] Fomepizole (15mg/kg loading dose then 10mg/kg Q12H) is preferred over ethanol due to its easier dosing regime and better side-effect profile (sadly not currently available in Australia). […] The indications to commence antidotal therapy are: Serum concentration of methanol / ethylene glycol 20 mg/dL. […] Metabolic acidosis with an arterial pH 7.3 should be treated with a sodium bicarbonate infusion to keep the pH between 7.35 and 7.45. […] The indications for haemodialysis in methanol / ethylene glycol poisoning are: Metabolic acidosis (pH 7.25-7.30), Visual abnormalities, Renal failure, Electrolyte abnormalities not responsive to conventional treatment, Haemodynamic instability refractory to ICU treatment, Serum concentration 50mg/dL.

• #33 Toxic Alcohol Ingestion • LITFL • CCC Toxicology

  https://litfl.com/toxic-alcohol-ingestion/

  Administration of cofactors will promote the conversion of intermediate metabolites into non-toxic metabolites: In ethylene glycol toxicity, pyridoxine (100mg IV Q6H) and thiamine (100mg IV Q6H) increase the metabolism of glycolic and glycoxlic acid to the less toxic metabolites glycine and alpha-hydroxy-beta-ketoadipate. […] In methanol toxicity, folic acid (50mg IV Q4-6H) or folinic acid (1-2mg/kg IV Q4-6H) increases the breakdown of formic acid to carbon dioxide and water. […] In comparison to other toxic alcohols, isopropanol intoxication is usually managed supportively. […] Haemodialysis may increase the rate of elimination of both isopropanol and acetone, and should be considered for patients with deteriorating GCS or haemodynamic instability.

• #34 Ethanol Toxicity – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK557381/

  All patients who present to the emergency department for acute alcohol intoxication should be screened for alcohol use disorder. If a patient is found to have alcohol use or dependence, they should be referred for alcohol treatment. In patients who consume alcohol at harmful levels, it is important to intervene early. Presentation to the emergency department for drunkenness should be considered an indicator of pathological use. […] In cases of suspected or known alcohol toxicity, the entire interprofessional healthcare team must work to achieve improved patient outcomes. This team includes clinicians, mid-level practitioners, nurses, pharmacists, and mental health professionals, who can play a crucial role in recovery following alcohol toxicity in those patients with alcohol use disorder. The interprofessional approach with shared information increases the chances of successful recovery.

• #35 Toxic alcohol poisoning – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/toxic-alcohol-poisoning/

  Toxic alcohol poisoning is a potentially life-threatening condition caused by the ingestion of toxic alcohols, which are either themselves toxic (e.g., isopropyl alcohol) or have toxic metabolites (e.g., methanol, ethylene glycol). […] Management of methanol and ethylene glycol poisoning involves treatment with fomepizole, with severe cases requiring hemodialysis. Patients often require admission for further monitoring and treatment. […] All patients: Provide general management of toxic alcohol poisoning. […] Antidote: Administer alcohol dehydrogenase inhibitors (e.g., fomepizole). […] Administer an antidote for toxic alcohol poisoning (e.g., fomepizole) if indicated. […] Consider hemodialysis in patients with any of the following: Neurologic symptoms (e.g., coma, seizures). […] Admit patients with methanol poisoning for treatment and monitoring. […] Admit patients with ethylene glycol poisoning for treatment and monitoring. […] Antidotes for toxic alcohol poisoning are not required for isopropyl alcohol poisoning. […] All patients: Begin general management of toxic alcohol poisoning.

• #36 Isopropanol overdose Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/poison/isopropanol-overdose

  Seek medical help right away. Do not make the person throw up unless poison control or your health care provider tells you to. If the isopropanol is on the skin or in the eyes, flush with lots of water for at least 15 minutes. […] If the isopropanol was swallowed, give the person water or milk right away, unless a provider tells you not to. Do not give anything to drink if the person has symptoms that make it hard to swallow. These include vomiting, seizures, or a decreased level of alertness. If the person breathed in the isopropanol, move them to fresh air right away. […] Treatment may include: […] Fluids through a vein (by IV) […] Tube through the nose into the stomach to empty the stomach, if the person took more than one swallow and arrives within 30 to 60 minutes after swallowing it (especially in children)

• #37 Isopropanol overdose Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/poison/isopropanol-overdose

  Dialysis (kidney machine) (in very rare cases) […] Breathing support, including a tube through the mouth into the lungs and connected to a breathing machine (ventilator). […] How well someone does depends on the amount of poison swallowed and how quickly treatment is received. The faster someone gets medical help, the better the chance for recovery.

• #38 Alcohol Poisoning: Signs, Causes, Treatment | Canadian Centre for Addictions

  https://canadiancentreforaddictions.org/ccfas-guide-on-alcohol-poisoning-signs-causes-and-treatment/

  Alcohol poisoning is a severe medical condition that requires urgent medical intervention. Hospital staff often monitor patients until their blood alcohol concentration drops to safe levels. In severe cases, they may administer the following alcohol poisoning remedies: […] IV fluids treat dehydration and increase vitamin and blood sugar levels. […] If the patient has difficulty breathing, hospital staff will administer supplemental oxygen by inserting a cannula into the windpipe. […] Stomach pumping involves using a nasogastric tube to rid the patient’s stomach of alcohol and other toxins. When the stomach is pumped, alcohol is expelled via the tube, preventing BAC from rising further. […] In some cases, dialysis may be initiated to filter alcohol from the blood. Patients who have become incontinent may also require a urinary catheter. Children who have ingested alcohol-containing household products may also need dialysis to speed up the removal of alcohol from their system.

• #39 SciELO Brazil – Prevalence and risk of potentially adverse drug interactions in the treatment of acute alcohol poisoning Prevalence and risk of potentially adverse drug interactions in the treatment of acute alcohol poisoning

  https://www.scielo.br/j/bjps/a/y4s547vkRpsp7VMNKvBW4GP/

  The aim of this paper is to determine the profile of acute alcohol poisoning and to estimate the risk of potentially adverse drug interactions (ADIs) in patients intoxicated by alcohol when attended in emergency care at hospital. […] After treatment complete recovery from the signs or symptoms of the poisoning was observed in 96.88% cases; and death in 0.70%. […] The measurement of ADIs aims to prevent clinical complications in medical care for alcohol misuse disorders. […] The potential risk of ADIs was observed in 182 (60.60%) prescriptions. […] The population under study showed a high risk of potential for the therapy not being effective and/or clinical injuries in emergency hospital-medical care. […] Therefore, co-administration of these drugs requires a suitable risk management, and rigorous patient care, in order to avoid adverse reactions and/or therapeutic ineffectiveness.

• #40 SciELO Brazil – Prevalence and risk of potentially adverse drug interactions in the treatment of acute alcohol poisoning Prevalence and risk of potentially adverse drug interactions in the treatment of acute alcohol poisoning

  https://www.scielo.br/j/bjps/a/y4s547vkRpsp7VMNKvBW4GP/

  Moderate risk of ADIs was observed in 92.40% of cases. […] Severe risks of ADIs have proved to be less frequent (4.60%). […] Although metoclopramide (an antiemetic drug) has been widely used in alcohol poisoning treatment, being the most frequently drug used (10.38%), it entails moderate and severe potential risk of ADIs. […] The use of psychoactive drugs for the management of anxiety, agitation and/or aggression, typical adverse events resulting from acute alcohol poisoning, requires a thorough control in pharmacotherapy and clinical monitoring of patients in emergency hospital-medical care. […] The potential risks described above show the lack of preparation in hospital teams in relation to the drug interaction issue, during routine hospital-medical care of patients intoxicated by alcohol. […] The measurement of possible drug interactions aims to contribute to the prevention of potential clinical complications in hospital-medical care of alcohol misuse disorders.

• #41 How To Treat Alcohol Poisoning: Signs, Treatment & Prevention

  https://www.palmerlakerecovery.com/alcohol-abuse-and-addiction/treat-alcohol-poisoning/

  Recovery time varies depending on several factors: Amount of Alcohol Consumed: A higher BAC may mean a longer recovery period. Individual Health: A persons liver function, metabolism, and overall health all influence how quickly they recover. Aftercare: Adequate hydration, nutrition, and rest can speed up recovery. In most cases, it takes the body one to two days to fully metabolize and recover from an acute alcohol overdose, although lingering fatigue, headache, and malaise can last longer. For someone with chronic heavy alcohol use, recovery can be more complicated, especially if liver damage or other organ issues are present. In some instances, an alcohol overdose can lead to permanent health consequences, including brain damage from lack of oxygen or severe dehydration.

• #42 Does Alcohol Poisoning Go Away? How Long It Lasts

  https://www.columbusrecoverycenter.com/alcohol-addiction/signs-alcohol-poisoning/

  Alcohol poisoning will go away as your body metabolizes alcohol, typically within 24 hours. However, it will often be fatal before it goes away. […] Anyone with alcohol poisoning needs immediate medical attention and will need to be hospitalized. […] Treatment for alcohol poisoning involves treating symptoms and maintaining life until the body metabolizes alcohol. […] You cannot get rid of alcohol poisoning by yourself. Someone who is experiencing alcohol poisoning will need to be hospitalized to treat the symptoms it causes until your body rids itself of alcohol. […] Recovering from alcohol poisoning usually takes place in the hospital. Doctors will be able to monitor the person to make sure they stay safe. […] The person will also likely get an intravenous line for fluids to stay hydrated. The fluids also may contain substances to keep the person healthy during the detox process.

• #43 Does Alcohol Poisoning Go Away? How Long It Lasts

  https://www.columbusrecoverycenter.com/alcohol-addiction/signs-alcohol-poisoning/

  Other symptoms linked to alcohol overdose may also be treated. […] If someone survives for 24 hours after alcohol poisoning, they will typically recover. However, the person may develop alcohol withdrawal syndrome or AWS if they stop using alcohol after the incident. […] To monitor for signs of withdrawal, doctors may keep the person in the hospital for 72 hours after their BAC has gone down to zero.

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