Acute alcohol intoxication – Pharmacology B. Pharma 5th Semester PDF Notes

Acute Alcohol Intoxication

Content

Alcohol

       Acute alcohol intoxication

       Methanol poisoning and its treatment

       Mechanism of disulfiram

       Drugs used for the treatment of alcohol dependence

Intended Learning Outcomes

At the end of this lecture, student will be able to

       Explain acute alcohol intoxication

       Explain methanol poisoning and its treatment

       Outline the mechanism of disulfiram

       List the drugs used for the treatment of alcohol dependence

Acute alcohol intoxication

Life Threatening signs of alcohol poisoning include:

Inability to Wake up

Irregular breathing (10 second or more between breaths)

Vomiting

Seizures

Slow breathing (fewer than 8 breaths per minute)

Hypothermia (Low body temperature), bluish skin color, paleness

Acute alcohol intoxication

       600ml of pure alcohol in 70 Kg bodyweight: Fatal effect

       Coma due to CNS depression, severe hypoglycemia

 Treatment

       Maintenance of vital functions

       Thiamine 100 mg (Bolus IV)

       Glucose 50% 50 ml IV for hypoglycemia

       MgSO4 2-4g IV over 1-2 hrs

Chronic alcoholism

Neuropsychiatric syndromes

       Korsakoff’s psychosis, hallucinosis, suicidal tendencies, Wernicke’s encephalopathy

Nutritonal deficiencies

       Polyneuritis due to thiamine deficiency & anaemia

Organ damage leading to

       Hepatic cirrhosis, chronic pancreatitis, cardiomyopathy, optic nerve degeneration

Alcohol dependence

       Precise mechanism not known

       Upregulate NMDA receptor & voltage sensitive calcium channel

       Down regulate GABAA mediated ressponses

       Treatment:

      Detoxification

      rehabilitation

Drugs for Alcohol dependence

       Aversion drugs: Disulfiram, citrated Ca cyanide

       Opioid antagonist: Naltrexone, Nalmefene

       Dopamine Antagonist: Tiapride

       NMDA Antagonist: Acamprosate

       Supporting drugs: Lithium, carbamazepine, topiramate

Disulfiram

       12 hours alcohol free

       500 mg as single daily dose  for 1-2 weeks

       125 – 250 mg OD as maintenance dose

       Continued upto 1 year

       Inhibits aldehyde dehydrogenase

       Inhibits dopamine beta oxidase

Alcohol

       Drug interactions

      Inhibits metabolic degradation of warfarin, theophylline, benzodiazepine, carbamazepine,
tricyclic antidepressants

       contraindications

      Hepatic and circulatory diseases

      Uncontrolled DM

      Alcoholics with obvious personality changes

Methyl Alcohol

 

Pharmacological Actions

       Initial symptoms similar to ethanol

       Later symptoms due to:

       CNS depression

       Acidosis: because of formic acid and other organic acids

       Toxic effects of formaldehyde & formic acid on retinal cells

       Delayed symptoms

       Headache vertigo, nausea, vomiting

       Severe abdominal pain

       Dyspnoea

       Motor restlessness

       Bradycardia

       Coma followed by death

       Preceded by blindness

Treatment

       Hospitalization & nursing care

       Gastric lavage, activated charcoal

       Treatment of acidosis/ hypoglycemia

       Inhibition of methanol metabolism: ethanol, fomepizole

       Promotes metabolic degradation of formate

       Folinic acid 1mg/Kg IV wih folic acid img/Kg IV 4 hourly for 6 doses

       Hemodialysis in severe case

FAQs

  1. What is considered binge drinking?
    • Binge drinking is typically defined as consuming five or more alcoholic drinks within a short timeframe, usually within two hours.
  2. How does alcohol affect mental health?
    • Alcohol can contribute to mental health issues such as depression and anxiety, and excessive consumption may exacerbate pre-existing conditions.
  3. Can someone recover from alcohol dependence?
    • Yes, with the right support and treatment, individuals can recover from alcohol dependence and lead fulfilling lives.
  4. Are there legal consequences for providing alcohol to a minor?
    • Yes, providing alcohol to a minor is illegal and can result in legal repercussions.
  5. How can communities support those struggling with alcoholism?
    • Communities can provide support through education, access to resources, and fostering a non-judgmental environment for individuals seeking help.

Summary

       Chronic alcoholism leads to Korsakoff’s psychosis, hallucinosis, suicidal tendencies, wernicke’s encephalopathy Hepatic cirrhosis, chronic pancreatitis, cardiomyopathy, optic nerve degeneration

       Regular consumption of alcohol associated with hypertension and conduction defects

       Methanol poisoning: Coma preceded by blindness

       Hemodialysis in severe case of methanol poisoning

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