Alcohol intoxication

Hypoglycemia and alcohol intoxication Alcohol is metabolized in the liver by two oxidation reactions (Figure 23.15). Ethanol is fist... 

Ferreira, S. E., Tulio dc Mclio, M., Pompeia, S., fk Oliveira dc Soiiza-Formigoni, M. L. (2006). Effects of energy drink ingestion on alcohol intoxication. Alcoholism Clinical and Experimental Research, 30, 598-605. 

Glassification of Substance-Related Disorders. The DSM-IV classification system (1) divides substance-related disorders into two categories (/) substance use disorders, ie, abuse and dependence and (2) substance-induced disorders, intoxication, withdrawal, delirium, persisting dementia, persisting amnestic disorder, psychotic disorder, mood disorder, anxiety disorder, sexual dysfunction, and sleep disorder. The different classes of substances addressed herein are alcohol, amphetamines, caffeine, caimabis, cocaine, hallucinogens, inhalants, nicotine, opioids, phencyclidine, sedatives, hypnotics or anxiolytics, polysubstance, and others. On the basis of their significant socioeconomic impact, alcohol, nicotine, cocaine, and opioids have been selected for discussion herein. 

Poly(vinyl alcohol) has a low oral toxicity rating. The oral LD q is higher than 10,000 mg/kg (rats). Concentrations of up to 10,000 mg/L in water were tested for toxicity to bluegik sunfish. No mortaUty or response indicative of intoxication was observed (283). 

Because alcohol intoxication may be simulated by many pathologic conditions, including diabetic acidosis, the postconvulsive depression of epilepsy, uremia, head injuries, and poisonings by any other central nervous depressant and some stimulants (280), a diagnosis of acute alcoholism should not be made casually chemical testing of blood, urine, or expired air is always desirable. 

Some authorities question whether dmnkeimess can result from the inhalation of ethyl alcohol vapors. Experience has demonstrated that in any event such intoxication is indeed rare (281). There is no concrete evidence that the inhalation of ethyl alcohol vapor will cause cirrhosis. Liver function is definitely impaired during alcohol intoxication (282), making the subject more susceptible to the toxic effects of chlorinated hydrocarbons. 

Ethanol, C2H5OH, is responsible for the effects of intoxication felt after drinking alcoholic beverages. When ethanol burns in oxygen, carbon dioxide, and water are produced. 

A martini, weighing about 5.0 oz (142 g), contains 30.0% by mass of alcohol. About 15% of the alcohol in the martini passes directly into the bloodstream (7.0 L for an adult). Estimate the concentration of alcohol in the blood (g/cm3) of a person who drinks two martinis before dinner. (A concentration of 0.0010 g/cm3 or more is frequently considered indicative of intoxication in a normal adult.)... 

The antianxiety drug s are contraindicated in patients with known hypersensitivity, psychoses, acute narrow-angle glaucoma, and shock. These drugp are also contraindicated in patients in a coma or with acute alcoholic intoxication with depression of vital signs. 

Ethanol also reduces the activity of the noradrenergic system in the locus coeruleus, and alterations in norepinephrine activity may account for some aspects of intoxication and the abstinence syndrome. The 0.2 antagonist clon-idine and the P-receptor antagonist propranolol reduce some symptoms of alcohol withdrawal (Bailly et al. 1992 Carlsson and Fasth 1976 Dobrydnjov et al. 2004 Kahkonen 2003 Petty et al. 1997 Wong et al. 2003). 

The pharmacodynamic effects of ethanol are complex, and any attempt to link its actions to specific neurotransmitters or isolated brain regions is simplistic. A complicated neural network involved in the actions of ethanol accounts for its reinforcing, intoxicating, and abstinence effects. At the present time, use of medications that target neurotransmitters and neuromodulators affected by ethanol represents a reasonable strategy for the development of pharmacotherapies that reduce the reinforcing effects of alcohol and the craving and withdrawal symptoms that commonly occur in the context of alcohol dependence. 

Kranzler HR, Van Kirk J Efficacy of naltrexone and acamprosate for alcoholism treatment a meta-analysis. Alcohol Clin Exp Res 23 1335-1341, 2001 Kranzler HR, Babor TF, Lauerman R Problems associated with average alcohol consumption and frequency of intoxication in a medical population. Alcohol Clin Exp Res 14 119-126, 1990... 

Low K, Crestani F, Keist R, et al Molecular and neuronal substrate for the selective attenuation of anxiety. Science 290 131-134, 2000 Luddens H, Pritchett DB, Kohler M, et al Cerebellar GABAA receptor selective for a behavioural alcohol antagonist. Nature 346 648—651, 1990 LupoloverY, Safran AB, Desangles D, etal Evaluation ofvisual function in healthy subjects after administration of Ro 15-1788. Eur J Clin Pharmacol 27 505-507, 1984 Maher JF, Schreiner GE, Westervelt FB Jr Acute glutethimide intoxication 1. clinical experience (twenty-two patients) compared to acute barbiturate intoxication (sixty-three patients). Am J Med 33 70-82, 1962 Marks J The Benzodiazepines Use, Overuse, Misuse, Abuse. Baltimore, MD, University Park Press, 1978... 

Lyvers M, Hashing P Have Halpern et al. (2004) detected residual neuropsychological effects of MDMA not likely. Drug Alcohol Depend 75 149-152, 2004 Mack RB Marching to a different cactus peyote (mescaline) intoxication. N Engl J Med 47 137-138, 1986... 

Studies of the intoxicating effects of toluene showed that the inhalation of its vapor at a concentration of 200 ppm was associated with the development of mild-to-moderate intoxication, characterized by sedation, paresthesias, and hyporeflexia. Toluene vapor concentrations of 600-800 ppm induced a confusional state, whereas greater concentrations produced an intense euphoria (Benignus 1981 Press and Done 1967). In humans, plasma concentrations of toluene of 10-100 pM have been reported to be intoxicating these concentrations are close to the intoxicating concentrations of alcohol and in-halational anesthetics (Miller 1985). 

Dohrn CS, Lichtor JL, Finn RS, et al Subjective and psychomotor effects of nitrous oxide in healthy volunteers. Behav Pharmacol 3 19-30, 1992 Dohrn CS, Lichtor JL, Coalson DW, et al Reinforcing effects of extended inhalation of nitrous oxide in humans. Drug Alcohol Depend 31 263-280, 1993 Evans AC, Raistrick D Phenomenology of intoxication with toluene-based adhesives and butane gas. Br J Psychiatry 130 769-773, 1987 Evans EB, Balster RL CNS depressant effects of volatile organic solvents. Neurosci Biobehav Rev 13 233—241, 1991... 

In research and clinical treatment of substance use disorders, pharmacotherapy and psychotherapy are frequently combined. Medication is often used as a maintenance drug, to reduce cravings or intoxication, or to produce aversion to a substance, while the focus of psychotherapy may be to encourage abstinence, teach the patient new coping skills, or improve motivation to address drug or alcohol problems. 

Sinaceur, J., Ribiere, C., Sabourault, D. and Nordmann, R. (1985). Superoxide formation in liver mitochondria during ethanol intoxication possible role in alcohol toxicity. In Free Radicals in Liver Injury (eds. G. Poli, K.H. Cheeseman, M.U. Dianzani and T.F. Slater) pp. 175-177. IRL Press, Oxford. 

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