Materiały źródłowe

• #1 Alcohol Poisoning Symptoms & Treatment

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

  Alcohol poisoning happens when excess alcohol in your bloodstream starts affecting life-supporting functions, like your breathing, heart rate and consciousness. Alcohol poisoning can be life-threatening and needs immediate medical care. […] Alcohol poisoning happens when theres so much alcohol in your bloodstream that it starts shutting down life-supporting areas of your brain. These areas control your breathing, heart rate and temperature. Alcohol poisoning is life-threatening. […] Alcohol poisoning typically happens when you consume a large amount of alcohol in a short amount of time. […] As your body digests and absorbs alcohol, the alcohol enters your bloodstream. Your blood alcohol content (BAC) begins to rise. Your liver breaks down alcohol to remove it from your body because its a toxin. But when BAC levels are high, your liver cant remove the toxins quickly enough.

• #2 Alcohol poisoning: symptoms and recovery

  https://www.allencarr.com/en-us/articles/alcohol-poisoning-2/

  Alcohol poisoning is a serious and potentially life-threatening condition resulting from consuming a toxic amount of alcohol, typically within a short period. […] Understanding the signs, causes, and recovery process associated with alcohol poisoning is crucial for anyone who consumes alcohol or has loved ones who do. […] Alcohol poisoning occurs when an individual drinks a large amount of alcohol quickly, overwhelming the liver’s ability to process it. […] When alcohol levels in the bloodstream rise too high, the brain’s functions are severely disrupted, affecting areas that control basic survival functions, such as breathing and heart rate. In extreme cases, alcohol poisoning can be fatal. […] Alcohol poisoning primarily results from binge drinking, but it can also occur from drinking large quantities of alcohol over an extended period.

• #3 Ethanol Toxicity – StatPearls – NCBI Bookshelf

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

  Ethanol toxicity results from the ingestion of large amounts of ethanol, usually in the form of alcohol. […] Ethanol toxicity can occur in both acute and chronic settings, representing two different spectrums of disease. Acute ethanol intoxication usually follows the ingestion of a large amount of alcohol and is a clinically harmful condition. […] Alcohol is absorbed through the proximal GI tract. It is primarily metabolized in the liver by alcohol dehydrogenase to acetaldehyde. The primary site of action in acute toxicity is the central nervous system, where it increases central nervous system (CNS) inhibition and decreases excitation. Gamma-aminobutyric acid (GABA) is the primary CNS inhibitory neurotransmitter. GABA binds to receptors allowing chloride to enter the cell, which decreases cellular excitability. Alcohol binds strongly to GABA receptors, activating the inhibitory cascade, which results in sedation, cognitive dysfunction, and decreased coordination.

• #4 Alcohol Toxicity: Practice Essentials, Pathophysiology, Epidemiology

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

  Ethyl alcohol (ethanol; CH3-CH2-OH) is a low molecular weight hydrocarbon that is derived from the fermentation of sugars and cereals. It is widely available both as a beverage and as an ingredient in food extracts, cough and cold medications, and mouthwashes. […] Ethanol is rapidly absorbed across both the gastric mucosa and the small intestines, reaching a peak concentration 20-60 minutes after ingestion. Once absorbed, it is converted to acetaldehyde. This conversion involves three discrete enzymes: the microsomal cytochrome P450 isoenzyme CYP2E1, the cytosol-based enzyme alcohol dehydrogenase (ADH), and the peroxisome catalase system. Acetaldehyde is then converted to acetate, which is converted to acetyl Co A, and ultimately to carbon dioxide and water. […] Genetic polymorphisms coding for alcohol dehydrogenase, the amount of alcohol consumed, and the rate at which ethanol is consumed all affect the speed of metabolism. As a general rule, ethanol is metabolized at a rate of 20-25 mg/dL; however, persons with alcohol use disorder metabolize ethanol more rapidly.

• #5 Alcohol poisoning | PPT

  https://www.slideshare.net/imtiazurrehman50/alcohol-poisoning-72293529

  1. Alcohol poisoning can occur from both acute and chronic alcohol consumption and has effects throughout the body, especially the central nervous system, gastrointestinal tract, and liver. […] […] 2. MECHANISMOF ACTION FORMIC ACID ACIDOSIS TISSUE HYPOXIA LACTIC ACID PRODUCTION CIRCULATORY FAILURE INHIBITION OF MITOCHONDRIAL RESPIRATION CIRCULUS HYPOXICUS METHANOL FORMALDEHYDE […] […] 3. Absorption of ethanol is by simple diffusion 25% of an ingested dose of ethanol is absorbed from the stomach 75% of an ingested dose of ethanol is absorbed from the small intestine. […] […] 4. Fatal Dose Logically there is no specific fatal dose. It is the blood alcohol concentration (BAC) that Specifies the lethal dose. (350mg%) Fatal dose vary from person to person. […] […] 5. Effects of Acute Alcohol poisoning on Body CNS effects GIT effects Respiratory effects Urinary effects Reproductive Heart. […]

• #6 Symptoms of Alcohol Poisoning and Overdose – Spot the Signs

  https://www.castlecraig.co.uk/alcohol-addiction/effects-risks/poisoning-overdose/

  Alcohol poisoning, which is also known as alcohol overdose, is caused by drinking a lot in a short period of time. Your body can only break down around one unit of alcohol an hour so if you drink more than that, your system can quickly become overwhelmed. […] Alcohol poisoning can be fatal in other ways. If you flood your system with booze, your judgement becomes clouded and your reflexes slow. This can lead to accidents, making risky decisions or becoming violent; all of which can have catastrophic consequences. […] Yes, it can. When there is too much alcohol in the bloodstream the brain can no longer control essential life-saving functions, such as breathing, heart rate, and body temperature. […] Alcohol poisoning impairs your gag reflex which means if you vomit while passed out or even asleep, you could easily choke to death.

• #7 Toxic Alcohol Poisoning | RECAPEM

  https://recapem.com/toxic-alcohol-poisoning/

  Alcohols are rapidly absorbed from the gastrointestinal tract. Once absorbed, they have a volume of distribution similar to that of body water (~0.6 L/kg) with peak blood concentrations occurring within one hour. Subsequently, they are metabolized in the liver or excreted primarily by the kidney. […] The toxic alcohols are inebriating but are not directly toxic, except for isopropanol. Their toxic effects result from their metabolites. […] Metabolic conversion explains biphasic clinical and laboratory findings: Initially, clinical findings are due to parent alcohol; later on, they are due to toxic metabolites. […] Laboratory findings initially show elevated levels of parent toxic alcohol; later this disappears, and only acid metabolites are seen. […] Formic acid accounts for the toxicity and metabolic acidosis. Formate is a mitochondrial toxin, inhibiting cytochrome oxidase and thereby interfering with oxidative phosphorylation.

• #8 Current View on the Mechanisms of Alcohol-Mediated Toxicity

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8472195/

  Alcohol is a psychoactive substance that is widely used and, unfortunately, often abused. […] This work focuses on reviewing actual knowledge about the toxic effects of ethanol and its degradation products. […] Acute intoxication is often the limit for ending ongoing consumption. […] The danger of alcohol consumption lies primarily in alcohol addiction, leading to chronic abuse and organ damage. […] Although the mentioned organs/systems perform different functions, the distribution and metabolization of ethanol in organs/systems are variable. […] There is also a relationship between chronic alcohol abuse and many types of cancer. […] Ethanol passes freely through the biological membranes according to the concentration gradient and quickly reaches equilibrium with the plasma content.

• #9 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

  One serving of alcohol (one 12-oz can of beer, one 6-oz glass of wine, or 1.5 oz of distilled liquor) contains 10 to 15 g of ethanol. Alcohol is absorbed into the blood mainly from the small bowel, although some is absorbed from the stomach. Alcohol accumulates in blood because absorption is more rapid than oxidation and elimination. The concentration peaks about 30 to 90 minutes after ingestion if the stomach was previously empty. […] About 5 to 10% of ingested alcohol is excreted unchanged in urine, sweat, and expired air; the remainder is metabolized, mainly by the liver, where alcohol dehydrogenase converts ethanol to acetaldehyde. Acetaldehyde is ultimately oxidized to CO2 and water at a rate of 5 to 10 mL/hour (of absolute alcohol); each milliliter yields about 7 kcal. Alcohol dehydrogenase in the gastric mucosa accounts for some metabolism; women have lower gastric alcohol dehydrogenase activity than men.

• #10 Pediatric Ethanol Toxicity: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/1010220-overview

  Ethanol is a 2-carbon chain alcohol; the chemical formula is CH2 CH3 OH. Ethanol has a volume of distribution (0.6 L/kg) and is readily distributed throughout the body. The primary route of absorption is oral, although it can be absorbed by inhalation and even percutaneously. […] Ethanol exerts its actions through several mechanisms. For instance, it binds directly to the gamma-aminobutyric acid (GABA) receptor in the CNS and causes sedative effects similar to those of benzodiazepines, which bind to the same GABA receptor. Furthermore, ethanol is also an N-methyl-D-aspartate (NMDA) glutamate antagonist in the CNS. Ethanol also has direct effects on cardiac muscle, thyroid tissue, and hepatic tissue. However, the exact molecular targets of ethanol and the mechanism of action are still the subjects of ongoing research.

• #11 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

  Alcohol exerts its effects by several mechanisms. Alcohol binds directly to gamma-aminobutyric acid (GABA) receptors in the central nervous system, causing sedation. Alcohol also directly affects cardiac, hepatic, and thyroid tissue. […] The physical dependence accompanying tolerance is profound, and alcohol withdrawal has potentially fatal adverse effects. […] Chronic heavy alcohol intake typically leads to liver disorders (eg, fatty liver, alcoholic hepatitis, cirrhosis); the amount and duration required vary. […] Alcohol-tolerant people are susceptible to alcoholic ketoacidosis, especially during binge drinking. Alcohol-tolerant people are cross-tolerant to many other central nervous system depressants (eg, barbiturates, nonbarbiturate sedatives, benzodiazepines). […] A continuum of symptoms and signs of central nervous system (including autonomic) hyperactivity may accompany cessation of alcohol intake.

• #12 What Happens to Your Brain When You Drink Alcohol?

  https://www.hackensackmeridianhealth.org/en/healthu/2018/12/27/what-happens-to-brain-drink-alcohol

  The consumption of alcohol directly influences specific processes of the brain, the command center of the body, which results in feeling inebriated. […] Getting drunk occurs when you consume alcohol faster than you can break it down. […] Alcohol is a depressant to our bodies. Some of the visible symptoms you are used to seeing in someone whos drunk slurred speech, loss of coordination, falling, loss of inhibition, passing out all of these side effects are a result of our brain cells communicating at a slower rate, explains Dr. Krel. […] Alcohol also increases the effects of GABA, an inhibitory neurotransmitter. By increasing the effects of GABA, responses in the brain are decreased this slowed neurotransmission results in slurred speech, identifies Dr. Krel. […] The actual mechanism of what happens during a hangover is still not clear but is thought to be a result of the toxicity of acetaldehyde on the body, changes in electrolytes, dehydration, and low blood sugar.

• #13 Ethanol Toxicity – StatPearls – NCBI Bookshelf

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

  With chronic alcohol use, the number of GABA receptors is increased, requiring more and more alcohol to create the same level of inhibition. This is a phenomenon known as tolerance. This tolerance partly explains the alertness of chronic alcohol users at blood alcohol levels that, in others, would cause coma or death. […] Alcohol also inhibits the primary excitatory neurotransmitter in the CNS, glutamate. Patients with alcohol use disorder have increased numbers of NMDA receptors and increased sensitivity of these receptors to glutamate. Due to the increased sensitivity of these receptors, patients with alcohol use disorder are at risk for seizures and hallucinations when alcohol is withdrawn.

• #14 Alcohol-Induced Seizures: Can Drinking Cause Seizures?

  https://www.columbusrecoverycenter.com/alcohol-addiction/alcohol-seizures/

  The GABA receptors that alcohol over-stimulates decrease the likelihood of seizures. When alcohol is gone, however, these receptors go from over-stimulated to temporarily under-stimulated as they try to adjust to normal. While under-stimulated, they create a reverse effect, making seizures more likely to occur until they readjust to the absence of alcohol, leading to alcohol withdrawal seizures. […] Delirium tremens is a serious, life-threatening complication of alcohol withdrawal. Someone with delirium tremens may have hallucinations, psychosis, heartbeat changes and high body temperature. Seizures often occur during delirium tremens but are not always a symptom of this condition. Withdrawal seizures also happen independently of delirium tremens, and having seizures during withdrawal doesn’t necessarily mean that delirium tremens is present.

• #15 Current View on the Mechanisms of Alcohol-Mediated Toxicity

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8472195/

  The enzyme saturates very quickly, and ethanol oxidation by ADH is considered the main pathway of metabolization and is active mainly in light or moderate drinking. […] Important by-products of this reaction are reactive oxygen species, which, together with disruption of the glutathione regeneration due to the consumption of NADPH + H+, contribute to oxidative stress, thus leading to tissue damage. […] Acetaldehyde produced by the oxidation of ethanol is classified as a category 2 carcinogen according to the Annex VI regulation (EC) 1272/2008. […] Acetaldehyde is a transient toxic intermediate. […] Acetaldehyde markedly increases TNF-, interleukin 8, and interleukin 1, increases lipid peroxidation damage, and decreases catalase activity in hepG2 cells. […] Of particular importance is the ethanol-induced oxidative stress, which contributes to various pathological conditions, such as inflammation or carcinogenesis, and causes dysfunction of barriers securing the homeostasis, including the intestinal or blood-brain barrier.

• #16 Current View on the Mechanisms of Alcohol-Mediated Toxicity

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8472195/

  Acetaldehyde reacts with a myriad of proteins forming unstable or stable adducts. […] High anti-MAA antibody titers have been associated with the severity of liver damage. […] Alcohol consumption can also indirectly modify many other factors, including hypoxia-inducible factor-1 (HIF-1), C3, C1qa, PKC, and inducible nitric oxide synthase, which all contribute to the development of steatosis. […] The gut microbiome also may contribute to ethanol-related liver damage via a change in gut permeability.

• #17

  https://www.cancervic.org.au/cancer-information/preventing-cancer/limit-alcohol/how-alcohol-causes-cancer

  Inside your body, ethanol (pure alcohol) is broken down into a toxic by-product called acetaldehyde. Ethanol and acetaldehyde damage cells by binding with DNA, leading to incorrect cell replication. […] Acetaldehyde is toxic and can cause permanent DNA damage, which can lead to cancer (for example, in the bowel). […] If too much alcohol is consumed the body cannot process the acetaldehyde fast enough. Acetaldehyde then builds up in the body. […] Acetaldehyde build up can cause irreversible DNA damage, which can lead to cancer (for example, in the bowel). […] DNA damage can cause cancer of the bowel, oesophagus, liver, breast, mouth, pharynx, larynx.

• #18 Alcohol Poisoning Symptoms & Treatment

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

  The extra alcohol in your bloodstream acts as a depressant. This means that it slows down your bodys normal functions. If you continue to drink (and drink quickly), your BAC continues to rise. The depressant effect becomes more and more intense. […] If the depressant effects begin affecting key functions of your body, like your breathing and consciousness, its considered alcohol poisoning. […] Alcohol poisoning can affect anyone. But several factors can increase your risk, including: […] The faster you drink alcohol in a short amount of time, the more at risk you are for alcohol poisoning. […] If someone has alcohol poisoning, they may need lifesaving treatment right away. […] Alcohol poisoning is serious. Someone who has too much alcohol to the point of an overdose can have the following complications: […] Alcohol poisoning is serious and potentially life-threatening. If you think someone has it, get them medical help as soon as possible.

• #19 Alcohol Poisoning Symptoms & Treatment

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

  Alcohol poisoning happens when excess alcohol in your bloodstream starts affecting life-supporting functions, like your breathing, heart rate and consciousness. Alcohol poisoning can be life-threatening and needs immediate medical care. […] Alcohol poisoning happens when theres so much alcohol in your bloodstream that it starts shutting down life-supporting areas of your brain. These areas control your breathing, heart rate and temperature. Alcohol poisoning is life-threatening. […] Alcohol poisoning typically happens when you consume a large amount of alcohol in a short amount of time. […] As your body digests and absorbs alcohol, the alcohol enters your bloodstream. Your blood alcohol content (BAC) begins to rise. Your liver breaks down alcohol to remove it from your body because its a toxin. But when BAC levels are high, your liver cant remove the toxins quickly enough.

• #20 Alcohol Poisoning Causes, Symptoms, Diagnosis and Treatment – Cura4U

  https://cura4u.com/conditions/alcohol-poisoning

  If these levels rise above 0.30%, it depresses the central nervous system and reduces the activity of all other systems as well, which may lead to irregular breathing, low heart rate, low respiratory rate, hypothermia, bluish discoloration of the skin, extreme confusion, irregular bowel movement, urinary incontinence, and seizures. […] A high percentage of BAC over 0.30% can be identified as alcohol poisoning, although this may vary depending on age, weight, and other factors. […] Acute alcohol poisoning requires emergency medical care in which the first step is to secure an open airway and prevent choking on vomit. […] In the case of children or adults with severe toxicity, hemodialysis is suggested to filter out excessive alcohol. […] The prognosis of alcohol poisoning depends upon the severity of the condition and quick access to a medical emergency. Most cases recover well if they are given immediate medical attention once the symptoms appear. Severe alcohol poisoning can lead to coma or even death if the level of alcohol consumption is too high or the affected person didn’t receive emergency treatment.

• #21 Sudden cardiac death after alcohol intake: classification and autopsy findings | Scientific Reports

  https://www.nature.com/articles/s41598-022-20250-3

  Previous studies have demonstrated that alcohol has a direct effect on cardiomyocyte electrophysiology, but the arrhythmogenic potential of binge drinking may also be due to various other factors, e.g., concomitant tachycardia-induced ischemia, alcohol’s negative inotropic effect, sympathetic activation, vasodilation, metabolic alterations, or electrolyte disturbances. […] Interestingly, most of our alcohol-related SCDs occurred during the late stage of alcohol inebriation. The association between alcohol intake and SCD seems to be somewhat analogous to alcohol intake and atrial fibrillation, which also occurs mostly several hours after alcohol intake or during the late stage of inebriation, reinforcing the hypothesis that alcohol has the greatest arrhythmogenic potential during the late stage of inebriation. […] In conclusion, a significant proportion of SCDs occur immediately after alcohol intake and most of these events occur at the late stage of inebriation.

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

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

  Accidentally inhaling vomit into the lungs can lead to a dangerous or fatal interruption of breathing, also known as asphyxiation. […] Alcohol poisoning can cause a heartbeat that is not regular. It can even cause the heart to stop. […] Heavy drinking may cause brain damage that can’t be reversed. […] Any of the issues above can lead to death.

• #23 Sudden cardiac death after alcohol intake: classification and autopsy findings | Scientific Reports

  https://www.nature.com/articles/s41598-022-20250-3

  Alcohol is known to have an immediate effect on cardiac rhythm, and previous studies have found that a notable proportion of sudden cardiac deaths (SCD) occur after alcohol intake. […] We found that 1563 (27%) of all SCD victims had alcohol in blood or urine at autopsy (mean age (6110 years, 88% male). Eighty-six percent of alcohol-related SCD victims had higher urine alcohol concentration than blood alcohol concentration, referring to the late-stage inebriation. These results suggest that the majority of alcohol-related SCDs occur at the late stage of inebriation. […] Given that myocardial structural abnormalities are known to create an anatomic substrate that can maintain lethal ventricular arrhythmias leading to SCD, it is reasonable to hypothesize that alcohol intake may act as a trigger for lethal arrhythmias among those with pre-existing structural cardiac disease, either ischemic or non-ischemic.

• #24

  https://myhealth.alberta.ca/Alberta/Pages/alcohol-poisoning.aspx

  Alcohol is a depressant that impacts the whole body, including the central nervous system (the brain), cardiovascular system (the heart), and respiratory system (the lungs and breathing). […] When someone drinks too much alcohol or too quickly, it can overwhelm or suppress the healthy performance of these systems in the body. This can lead to the person passing out or having alcohol poisoning. A person can die from alcohol poisoning if their respiratory system (breathing) shuts down.

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

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

  Alcohol poisoning is a serious and sometimes deadly result of drinking large amounts of alcohol in a short period of time. […] Alcohol poisoning generally results from drinking too many alcoholic beverages in a short period of time. […] A major cause of alcohol poisoning is binge drinking. This is when a male rapidly consumes five or more alcoholic drinks within two hours or a female consumes at least four drinks within two hours. […] Even when the person is unconscious or stops drinking, the stomach and intestines continue to release alcohol into the bloodstream, and the level of alcohol in the body continues to rise. […] The more you drink, especially in a short period of time, the greater your risk of alcohol poisoning. […] Alcohol may cause vomiting. Because it depresses the gag reflex, this increases the risk of choking on vomit if a person passes out.

• #26 Alcohol-induced Vomiting can be Fatal – The Alcohol Pharmacology Education Partnership

  https://sites.duke.edu/apep/module-2-the-abcs-of-intoxication/explore-more/alcohol-induced-vomiting-can-be-fatal/

  Alcohol is irritating to the stomach. […] There are nerve endings in the stomach that send a signal to the brain that something harmful is present. […] Also, an area of the brainstem senses the amount of alcohol in the blood, and if its high, the brain responds by sending a neural signal back down to the stomach to get rid of the alcohol-i.e., vomit. […] This is a protective mechanism against drinking too much alcohol. […] However, vomiting when intoxicated or drunk can cause death by aspiration pneumonia. […] At high concentrations of alcohol in the body, the muscles that control the epiglottis become slow to react or even paralyzed and any food that is vomited up from the stomach may find its way back down into the breathing tube, especially if one is taking in a breath (aspiration). […] When the acidic stomach contents reaches the lungs, it is corrosive to the lung tissue, and it triggers a rapid infection of the lungs that results in a fatal form of pneumonia.

• #27 Alcohol-Induced Seizures: Can Drinking Cause Seizures?

  https://www.columbusrecoverycenter.com/alcohol-addiction/alcohol-seizures/

  Alcohol poisoning can increase the risk of seizures beyond what simply using too much alcohol would. Alcohol poisoning can severely reduce your blood sugar levels, leading to hypoglycemia. Hypoglycemia causes seizures and is more likely to occur in those who use medicine to keep their blood sugar levels in a normal range. […] Alcohol poisoning can also lead to slow or absent breathing, reducing the amount of oxygen in the brain, a condition called hypoxia. This can lead to temporary and lasting brain damage and increase the likelihood of seizures. […] While drinking too much alcohol can increase the risk of seizures, most alcohol-related seizures occur during alcohol withdrawal, which happens when you’re dependent on alcohol and stop drinking. If a seizure occurs from alcohol withdrawal syndrome, it will most often happen within 12-48 hours.

• #28 Ethyl Alcohol (Ethanol) – Alcohols – Toxicology and Addiction – Diseases – McMaster Textbook of Internal Medicine

  https://empendium.com/mcmtextbook/chapter/B31.II.20.2.1.

  Ethanol is a central nervous system depressant. […] By inhibiting gluconeogenesis in the liver, it may cause hypoglycemia, especially in children or malnourished patients. […] Approximately 0.8 g/kg (1 mL/kg) of pure ethanol (roughly 3-4 drinks) will produce a blood ethanol concentration of 0.1 g/dL (equal to 100 mg/dL = 1 g/L = 0.1% = 21.7 mmol/L). […] In adults severe symptoms of ethanol intoxication may develop after ingestion of 1 to 1.5 mL/kg (50-100 mL) of pure ethanol. […] Death is usually associated with levels 80 to 90 mmol/L, but the lethal level may be much higher for chronic ethanol users. […] The clinical diagnosis of ethanol intoxication is often based on history, smell of alcohol or acetaldehyde, and presence of ataxia, nystagmus, and altered mental status. […] There are no known methods of decontamination. […] There is no commercially available antidote to ethanol. […] Hemodialysis is effective at removing ethanol but is rarely needed because most patients recover within a few hours with supportive care only.

• #29 What Happens to Your Brain When You Drink Alcohol?

  https://www.hackensackmeridianhealth.org/en/healthu/2018/12/27/what-happens-to-brain-drink-alcohol

  Prolonged use of alcohol is toxic to neurons and can result in neuron death. […] Since alcohol consumption impacts the hippocampus, the part of the brain involved in memory formation, overuse can result in memory impairment, Dr. Krel warns. […] Alcohol can permanently damage the liver and result in liver cirrhosis. […] If you have a dependency on alcohol, it is important to seek professional help. […] Wernicke- Korsakoff syndrome can occur in patients with prolonged alcohol use and is a result of Vitamin B1 (Thiamine) deficiency. […] You should also seek help if there are signs of alcohol poisoning; symptoms include decreased or irregular breathing, decreased heart rate, decreased body temperature, stupor, or seizures, recommends Dr. Krel.

• #30 How Alcohol Impacts the Brain | Northwestern Medicine

  https://www.nm.org/healthbeat/healthy-tips/alcohol-and-the-brain

  „Intoxication occurs when alcohol intake exceeds your body’s ability to metabolize alcohol and break it down,” explains Amanda Donald, MD, a specialist in addiction medicine at Northwestern Medicine. […] Alcohol interferes with the brain’s communication pathways. It can also affect how your brain processes information. […] If you reach a BAC of 0.25, you may have concerning signs of alcohol poisoning. At this time, all mental, physical and sensory functions are severely impaired. The risk for passing out, suffocation and injury is high. […] A BAC over 0.45 may cause death due to alcohol poisoning or failure of the brain to control the body’s vital functions. […] Alcohol abuse can increase your risk for some cancers as well as severe, and potentially permanent, brain damage. It can lead to Wernicke-Korsakoff syndrome (WKS), which is marked by amnesia, extreme confusion and eyesight issues. WKS is a brain disorder caused by a thiamine deficiency or lack of vitamin B-1.

• #31 Alcohol-Induced Seizures: Can Drinking Cause Seizures?

  https://www.columbusrecoverycenter.com/alcohol-addiction/alcohol-seizures/

  Misusing alcohol can increase your overall risk of developing epilepsy. Heavy alcohol use of three or more drinks in a day can also increase the frequency of seizures in those who already have epilepsy. […] Seizures may cause lasting brain damage in many ways. In severe cases, seizures can last more than five minutes or reoccur repeatedly; this is a dangerous condition called status epilepticus. Status epilepticus is a medical emergency and can lead to lasting, irreversible brain damage. […] Seizures can also lead to brain damage in other ways. While a seizure may not damage the brain, it can make someone suddenly fall and be unable to catch themselves. This can cause head injuries and irreversible brain damage. Seizures can also disrupt the oxygen supply to the brain, potentially leading to permanent brain damage.

• #32 Methyl Alcohol (Methanol) – Alcohols – Toxicology and Addiction – Diseases – McMaster Textbook of Internal Medicine

  https://empendium.com/mcmtextbook/chapter/B31.II.20.2.2.

  Methanol is metabolized by alcohol dehydrogenase to formaldehyde, which is then converted to formic acid by aldehyde dehydrogenase. […] Severe metabolic acidosis develops secondary to formic acid accumulation as well as from lactate production due to inhibition of mitochondrial cytochrome c oxidase by formic acid. […] Formic acid accumulation can cause irreversible blindness from damage to the retina and optic nerve.

• #33 Toxic Alcohol Poisoning | RECAPEM

  https://recapem.com/toxic-alcohol-poisoning/

  Formic acid itself accounts for the metabolic acidosis early in the course of methanol poisoning. […] Glycolic acid itself accounts for metabolic acidosis early in the course of ethylene glycol poisoning. […] The toxicity of ethylene glycol poisoning is thought to be due to the direct cytotoxicity of glycolic acid and tissue damage from the precipitation of calcium oxalate crystals. […] Glycolate also impairs cellular respiration contributing to the development of lactic acidosis in some patients. […] The generation of these organic acid metabolites takes time, sometimes up to 16-24 hours for methanol. […] The cause of the elevated anion gap in toxic alcohol poisoning is primarily the organic acid metabolites. […] The elevated anion gap is not specific to toxic alcohol ingestion.

• #34 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). […] Methanol poisoning is associated with ophthalmologic pathologies (e.g., blurred vision, blindness), while ethylene glycol poisoning is associated with renal pathologies (e.g., hematuria, flank pain). […] An elevated osmolar gap with an anion gap metabolic acidosis suggests methanol or ethylene glycol poisoning. […] Elevated osmolar gap is classically an early feature of toxic alcohol ingestion. As methanol and ethylene glycol are metabolized, the osmolar gap decreases and a high anion gap metabolic acidosis (HAGMA) develops. […] Mechanism of toxicity: oxidation of methanol to formaldehyde by alcohol dehydrogenase conversion of formaldehyde to formic acid by formaldehyde dehydrogenase accumulation of formaldehyde and formic acid anion gap metabolic acidosis cellular toxicity.

• #35 Toxic Alcohols | Toxicology Section

  https://www.acep.org/toxicology/newsroom/Oct2020/toxic-alcohols

  Ethylene glycol is metabolized to glycoaldehyde by ADH then to glycolic acid by ALDH which then is converted to glyoxylic acid and oxalic acid. The primary toxic metabolites are glycolic acid and oxalic acid, although glyoxylic acid likely contributes to the anion gap metabolic acidosis. […] Isopropanol is the exception among these three toxic alcohols. It is metabolized by ADH to acetone. This is due to isopropanol being a secondary alcohol, which are metabolized to ketones by ADH. Because acetone is not an aldehyde, it is not able to be further metabolized. This leads to a ketosis. Because there is no resulting formation of organic acids, there is no acidosis. Hence the mantra of Ketosis without acidosis. […] The hallmark metabolic abnormality that is associated with toxic alcohols is the development of a metabolic acidosis due to the organic acid metabolites. The acidosis can lead to general organ dysfunction, such as kidney injury, rhabdomyolysis, CNS depression and cardiotoxicity.

• #36 Alcohol Toxicity: Practice Essentials, Pathophysiology, Epidemiology

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

  Ethylene glycol itself is nontoxic, but it is metabolized into toxic compounds. Ethylene glycol is oxidized via alcohol dehydrogenase into glycoaldehyde, which then undergoes metabolism via aldehyde dehydrogenase into glycolic acid, promoting metabolic acidosis. […] The conversion to glycolic acid is somewhat rapid. In contrast, the conversion of glycolic acid to glyoxylic acid is slower and is the rate-limiting step in the metabolism of ethylene glycol. […] The oxalic acid combines with calcium to form calcium oxalate crystals, which accumulate in the proximal renal tubules, causing kidney injury. Autopsy studies have confirmed that the calcium oxalate crystals are deposited not only in the kidneys but in many other organs, including the brain, heart, and lungs. Hypocalcemia can ensue and cause coma, seizures, and dysrhythmias.

• #37 Toxic alcohol poisoning – Knowledge @ AMBOSS

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

  Mechanism of toxicity: hepatic metabolism of ethylene glycol accumulation of glycolic acid anion gap metabolic acidosis. […] Metabolism of glycolic acid accumulation of oxalic acid deposition of calcium oxalate crystal in renal tubules acute kidney injury. […] Mechanism of toxicity: directly toxic; metabolized in the liver to acetone.

• #38 Toxic Alcohols | Toxicology Section

  https://www.acep.org/toxicology/newsroom/Oct2020/toxic-alcohols

  The mainstay of treatment for methanol and ethylene glycol is administration of fomepizole (4-methylpyrazole). This treatment should be given in any case where there is enough clinical suspicion for toxic alcohols, whether it is based on history indicating ingestion or lab abnormalities such as unexplained acidosis or presence of an osmolar gap. Fomepizole functions by inhibiting the action of alcohol dehydrogenase, preventing metabolism of toxic alcohols to their metabolites.

• #39 Toxic Alcohols | Toxicology Section

  https://www.acep.org/toxicology/newsroom/Oct2020/toxic-alcohols

  Methanol’s main claim to fame is visual impairment, which occurs on a spectrum ranging from blurry vision to complete blindness. The vision loss is often asymmetric. The formic acid is responsible for toxicity, as it inhibits oxidative phosphorylation, preferentially affecting cells in the optic nerve. […] Ethylene glycol’s most prominent effect is nephrotoxicity due to precipitation of oxalic acid with calcium to form calcium oxalate crystals. Consequently, hypocalcemia can occur along with resultant dysrhythmias. CNS toxicity leads to cerebral edema, cranial nerve deficits and seizures. […] Toxic alcohols are readily removed by extracorporeal removal techniques (ECRT), such as hemodialysis and continuous renal replacement therapy (CRRT). ECRT is particularly important consideration for patients with methanol poisoning, as methanol’s half-life is significantly increased in the presence of fomepizole.

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