Alcohol intoxication
The content of the article:
- Causes and risk factors
- Forms
- Stages
- Symptoms of alcohol intoxication
- Features of the course of the disease in children
- Diagnostics
- Treatment of alcohol intoxication
- Possible complications and consequences
- Forecast
- Prevention
Alcohol intoxication - a wide range of psychophysiological disorders caused by the action of ethyl alcohol and its decay products with the use of large amounts of alcohol and systematic abuse of alcoholic beverages.
Alcohol intoxication is the poisoning of the body with the decay products of ethyl alcohol
Causes and risk factors
The reason for alcohol intoxication is one - excessive alcohol consumption. Normally, two types of liver enzymes with different metabolic activity are responsible for the breakdown of ethyl alcohol molecules - alcohol dehydrogenase and acetaldehyde dehydrogenase. Alcohol dehydrogenase oxidizes ethanol to acetaldehyde, which is further metabolized by acetaldehyde dehydrogenase to harmless acetic acid.
The efficiency of ethanol breakdown varies widely depending on genetic factors, gender, age, health status, individual constitution and external conditions. The lower the activity of alcohol dehydrogenase and acetaldehyde dehydrogenase, the stronger the individual's predisposition to alcoholism and alcohol intoxication. The action of enzymes weakens against the background of malnutrition, chronic stress, lack of sleep, high strength and low quality of alcohol, etc. As a result, the concentration of pure ethanol and acetaldehyde in the bloodstream reaches a critical level faster, resulting in signs of intoxication even when consumed small doses of alcohol.
The only reason for alcohol intoxication is excessive alcohol consumption
In men, the content of alcohol dehydrogenase is on average higher than in women, and in children and adolescents it is an order of magnitude lower than in adults. Ethnicity also matters: some peoples have more advantageous combinations of alleles of genes encoding the structure of alcohol dehydrogenase and acetaldehyde dehydrogenase, while others have less successful genetic combinations.
Forms
Depending on the nature and duration of alcohol consumption, there are acute and chronic forms of alcohol intoxication. With a single intake of a large amount of alcohol in a person who does not regularly drink alcohol, acute alcohol intoxication occurs, in which the pathological process is localized mainly in the nervous system.
Occasionally, when alcohol is consumed, even in negligible amounts, some people develop pathological intoxication, characterized by a complete loss of control over themselves and a rapid increase in psychotic symptoms. The patient may be haunted by hallucinations, in some cases unmotivated aggression occurs. Being in an altered state of consciousness, the patient can commit an offense. The attack ends in deep sleep, and after waking up, the person does not remember what was happening.
Against the background of long-term alcoholism, a dangerous pathological condition develops - chronic alcohol intoxication, accompanied by damage to internal organs and systems. Among the typical manifestations of chronic alcohol intoxication:
- arterial hypertension;
- tremor;
- arrhythmia;
- myocardial dystrophy;
- chronic diseases of the gastrointestinal tract and genitourinary system;
- chronic hepatitis and pancreatitis;
- fatty hepatosis;
- muscle atrophy;
- disorders of cerebral circulation - up to cerebral ischemia and micro-strokes;
- alcoholic encephalopathy;
- delirious disorders.
Stages
Depending on the concentration of pure ethanol in the bloodstream, three degrees of acute alcohol intoxication are distinguished.
- Blood alcohol content less than 0.2%. Manifestations of intoxication are similar to those of mild intoxication; medical attention is usually not required.
- The blood alcohol level rises to 0.2–0.3%. Signs of damage to the central nervous system are growing: coordination of movements deteriorates sharply, speech becomes incoherent and illegible, facial expressions lose their expressiveness; dizziness and double vision appear; after an attack, a hangover syndrome develops.
- If the ethanol content in the blood exceeds 0.3%, the patient's life is threatened. Due to the strong suppression of the central nervous system, breathing disorders and arrhythmia are observed; the likelihood of developing an alcoholic coma and cardiac arrest is high.
Stages of alcohol intoxication
Symptoms of alcohol intoxication
Signs of acute alcoholic intoxication of mild to moderate degree are familiar to many firsthand:
- euphoria and emotional disinhibition;
- hyperemia of the face;
- sweating;
- muscle tremors;
- nausea and vomiting;
- dilated pupils;
- increased thirst;
- dizziness and severe headaches;
- inhibited facial expressions and gestures;
- fluent slurred speech;
- violations of concentration and slowing down of reaction;
- discoordinated movements and unsteadiness of gait;
- loss of the ability to objectively assess the situation.
With a severe degree of alcohol intoxication, loss of consciousness occurs
Severe alcohol poisoning is accompanied by severe depression of the central nervous system. Especially dangerous is the inhibition of the respiratory and vasomotor centers, which is manifested by obstructive breathing disorder, tachycardia and a sharp drop in blood pressure, sudden cardiac arrest. Symptoms of severe alcohol intoxication include loss of consciousness, memory impairment, jaw spasm, seizures, changes in muscle tone and tendon reflexes, and inability to control urination and defecation. At the same time, the size of the pupils is unstable, but tends to decrease, the reaction to light is weak, one pupil may be larger than the other. In order to avoid death, a patient in this condition should call an ambulance or take the victim to a hospital.
Features of the course of the disease in children
Children can be exposed to alcohol intoxication even in the prenatal period. The regular use of alcohol by a pregnant woman leads to systemic disorders of the intrauterine development of the fetus. As a result of alcohol intoxication transferred in the mother's womb, newborns have multiple congenital physical and mental pathologies classified as fetal alcohol effects or fetal alcohol spectrum disorders (FASD).
The severity of FASD in each case is not the same, since it is influenced by a number of factors - the frequency and volume of alcohol consumption, the quality and strength of alcoholic beverages, the state of health of the mother, the ecological situation in the region, socio-economic conditions, etc. The manifestation of FASD is fetal alcohol syndrome (FAS), also known as fetal alcohol syndrome (FAD), fetal alcohol syndrome, or alcoholic embryophetopathy. In pediatrics, there are three criteria for the diagnosis of FAS:
- pre- and postnatal deficit in height and body weight;
- neurological abnormalities: anatomical defects in brain structures, mental retardation, memory and attention disorders, learning disabilities and impaired control of emotions;
- characteristic features of the structure of the face and skull: microcephaly (decrease in the volume of the cranium), cleft palate (the so-called "cleft lip" and "cleft palate"), underdevelopment of the jaws, wide flat bridge of the nose, narrow and short palpebral fissure, epicanthus (skin fold at the inner corner of the eye), smoothing the labial groove.
In some cases, sick children have congenital heart defects, anomalies of the joints and genitals, disorders of fine motor skills, hearing and vision, capillary hemangiomas. The patient needs social support and medical supervision throughout his life; he is at increased risk of marginalization and severe alcohol dependence.
Diagnostics
With acute administration of alcohol, the diagnosis is made situationally: there are enough external signs of intoxication and the smell of alcohol emanating from the patient. In order to clarify the diagnosis, the Rappoport test is used - the detection of ethyl alcohol in the exhaled air.
To accurately determine the concentration of alcohol in blood and urine, the photometric method of Karandaev is used - a redox reaction between ethanol and potassium hydrochromate with the formation of chromium sulfate. Determination of alcohol content in other biological media is carried out by means of a serial photometric study, including up to ten analyzes. Enzymatic ADN-method and gas-liquid chromatography can be used as auxiliary methods.
The Rappaport test allows you to determine the level of ppm in the body
The chronic form of alcohol intoxication is most often detected during the examination of a patient with concomitant diseases.
Treatment of alcohol intoxication
In most cases, you can cope with mild to moderate alcohol intoxication on your own. To begin with, you should induce vomiting by pressing on the root of the tongue, and then drink as much water as possible and take an enterosorbent for the speedy removal of toxic metabolites of ethyl alcohol from the body.
When signs of severe poisoning appear, treatment of alcohol intoxication should be carried out in stationary conditions. While waiting for the arrival of the ambulance team, the victim must be laid on his side and his head raised in order to prevent asphyxiation by vomit. In the hospital, detoxification therapy is carried out - gastric lavage and intravenous infusion of detoxification solutions, and in case of alcoholic coma, tracheal intubation and artificial ventilation of the lungs are performed.
After the removal of acute symptoms for each patient, a drug therapy regimen is selected, which, according to indications, includes:
- psychotropic drugs: neuroleptics, tranquilizers, psychostimulants and analeptics;
- anticonvulsants;
- antispasmodics;
- vitamins: thiamine chloride, nicotinic and ascorbic acid;
- hepatoprotectors.
With alcohol intoxication, the body is detoxified
As a rule, the patient's condition can be normalized within 5-7 days. Detoxification therapy for chronic alcohol intoxication, occurring against the background of alcoholism, is carried out simultaneously with psychotherapeutic measures aimed at overcoming addiction.
Possible complications and consequences
Acute alcohol poisoning can provoke exacerbations of chronic diseases, hypertensive crises and acute disorders of cerebral circulation. Against the background of chronic alcohol intoxication, in some cases, alcoholic epilepsy and delirium develop - an acute psychotic state, accompanied by delusions, stereotypes and frightening hallucinations, which is popularly called delirium tremens. In the absence of medical supervision in fainting and coma, there is a likelihood of death due to cardiac arrest, asphyxiation with vomit; if the contents of the stomach enter the respiratory tract, aspiration pneumonia may develop.
Forecast
With timely assistance, acute alcohol poisoning ends in recovery even in cases where there was an alcoholic coma. In the chronic form, the prognosis depends on the patient's motivation to fight alcoholism and the depth of damage to internal organs.
Prevention
Absolute protection against alcohol poisoning is provided only by a complete refusal to use it, but the majority of the population does not consider this option due to cultural traditions. To reduce the harmful effect of ethanol on the nervous system, it is recommended to limit yourself to minimal portions of alcohol, avoid drinking low-quality alcohol and not mix different drinks. Considering that in case of hypoglycemia, the efficiency of ethanol utilization is an order of magnitude lower than normal, you should avoid drinking on an empty stomach, and during a feast combine alcoholic drinks with food rich in proteins and carbohydrates. In stressful situations, after illnesses and in severe fatigue from alcohol, it is better to abstain - the body's reaction to alcohol in such cases may be unpredictable.
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Anna Kozlova Medical journalist About the author
Education: Rostov State Medical University, specialty "General Medicine".
The information is generalized and provided for informational purposes only. At the first sign of illness, see your doctor. Self-medication is hazardous to health!
