(LAB) Alcohol Poisoning Flashcards
Alcohol preparation
a. Ethene hydration
b. Carbohydrate fermentation
Alcohol, USP
Ethanol
- Grain alcohol, Neutral spirit, Spiritus vini
Rectificatus, Jaysol, Dehydrated alcohol - Has a very characteristic odor and sharp
burning taste
Alcohol, USP (Ethanol)
Types of Alcohol
- 99% (dehydrated)
- 95% (absolute)
- 70% (rubbing)
- 50% (diluted)
- Denatured alcohol
Contaminants in denatured alcohol
Methanol and Benzene
Alcohol Uses
- Available at home, in drug and cosmetic formulation, solvent
- Antiseptic or disinfectant, rubefacient, carminative, mild local anesthesia, refrigerant
- In intoxicating beverages as CNS depressant
(T/F) Alcohol is subjected to substance abuse
True
(Alcohol derivative)
Fermented from: Malted barley
4-5%
Beer
(Alcohol derivative)
Fermented from: Fruit juice (grapes)
10-14%
White/Red wine
(Alcohol derivative)
Fermented from: Wine spirit
35-60%
Brandy
(Alcohol derivative)
Fermented from: Malted grain
40-60%
Whiskey
(Alcohol derivative)
Fermented from: Molasses
37.5-80%
Rum
(T/F) Mechanism of toxicity of alcohol is that all mucous membrane absorb alcohol very quickly and greater part is consumed in body
True
Pathways of alcohol metabolism
Alcohol dehydrogenase, Microsomal Ethanol Oxidase System (CYP2E1)
Alcohol metabolites
Acetaldehyde, Acetic Acid
Major metabolic pathway of EtOH
Alcohol dehydrogenase
(Acute/Chronic effect of Acetaldehyde) Flushing, headache, tachycardia, N&V
Acute
(Acute/Chronic effect of Acetaldehyde) Liver damage (free radical production)
Chronic
(T/F) Acetic acid is further broken into CO2 and H2O
True
Minor pathway in alcohol metabolism
Microsomal Ethanol Oxidase System (CYP2E1)
Alcohol Acute (low dose) S/S
- CNS Stimulation, Euphoria, Boisterous
- Mild incoordination
- Coma
- Respiratory depression
- Pulmonary aspiration
Alcohol Chronic (high dose) S/S
- CNS Depression
- Hypoglycemia
- Hypothermia
- Acid-base abnormalities
- Lactic acidosis
- Fatty liver
- Cardiomyopathy
Altered mental status; Unsteady posture/ Gait; Nystagmus; retinal hemorrhage. Ax: Vit B1 (Thiamine)
Wernicke Korsakoff syndrome
Microencephaly, Intellectual growth
retardation, retarded psychomotor
development; “Precious moments doll”
Fetal Alcohol Syndrome
“Precious moments doll”
Fetal Alcohol Syndrome
Acute Alcoholism
Enzyme inhibitor
Chronic Alcoholism
Enzyme inducer
Additive drug interaction (1+1=2)
Alcohol + CNS depressant → Sedation
Synergistic drug interaction (1 + 1 = 3)
Alcohol + CCl4
Cephalosporin/ Metronidazole + Alcohol
Disulfiram-like reactions
with warm water or sodium bicarbonate
Gastric lavage
induce vomiting
Ipecac syrup
demulcent
Mineral oil
stimulant, physiologic antidote
Caffeine
useful awakening agent
Methylphenidate
respiration aide, as needed
Oxygen
NSS or Sodium lactate solution for circulatory
collapse, dehydration and acidosis
Intravenous fluids
if with hypoglycemia
Glucose
to prevent Wernicke-Korsakoff Syndrome or for acute alcoholism
Thiamine or Vitamin B-complex
Treatment for metabolic Acidosis
NaHCO3
Corrects fluid & electrolyte imbalance/ acid
-base disturbance
Hemodialysis
Drain ascitic fluid in peritoneal cavity
Paracentesis
(T/F) It is important to keep a patient who has ingested toxic doses of alcohol coldly.
False. Keep the patient warm
(Antidote) Orphan drug for MeOH and Ethylene glycol poisoning
Fomepizole (Antizol®)
Ensure abstinence in the tx of alcohol
dependence
Disulfiram (Antabuse®)
Contraindicated with alcohol
Activated charcoal
