Alcohol poisoning , also known as drunk or alcohol poisoning , is a negative behavior and physical effect due to recent drinking of ethanol (alcohol). Symptoms at lower doses may include mild sedation and poor coordination. At higher doses, there may be slurred speech, walking difficulties, and vomiting. Extreme doses can lead to decreased attempts to breathe (respiratory depression), coma, or death. Complications may include seizures, aspiration pneumonia, injuries including suicide, and low blood sugar.
Alcohol poisoning usually begins after two or more alcoholic drinks. Risk factors include a social situation where heavy drinking is common and people have impulsive personalities. Diagnosis is usually based on history of events and physical examination. Verifying events by people with someone can be useful. Legal alcohol poisoning is often defined as blood alcohol concentration (BAC) greater than 5.4-17.4 mmol/L (25-80 mg/dL or 0.025-0.080%). This can be measured by blood or breath tests. The alcohol is then broken down at a rate of about 3.3 mmol/L (15 mg/dL) per hour.
Alcohol poisoning management involves supportive care. Usually this includes putting people in a recovery position, keeping them warm, and making sure they breathe adequately. Active gastric and charcoal rays have not proven useful. Repeated assessment may be necessary to rule out other potential causes of a person's symptoms.
Alcohol poisoning is very common, especially in the Western world. Most people who drink alcohol ever get drunk. In the United States, acute intoxication directly produces about 2,200 deaths per year, and indirectly more than 30,000 deaths per year. Acute poisoning has been documented throughout history and alcohol remains one of the most extensive recreational drugs in the world. Some religions think alcohol poisoning is a sin.
Video Alcohol intoxication
Signs and symptoms
Alcohol poisoning is a negative health effect due to recent drinking of ethanol (alcohol). When it is severe it can be a medical emergency. Some of the effects of alcohol poisoning, such as euphoria and lowering social inhibition, are central to the desire for alcohol.
Signs and symptoms of acute alcohol poisoning include:
- severe confusion, unexpected behavior and fainting
- deviation suddenly in and out of unconsciousness or semi-consciousness (with subsequent alcoholic amnesia)
- vomiting when unconscious or semi-conscious
- seizures
- respiratory depression (less than eight breaths per minute)
- pale skin, bluish, cold and sweaty because of insufficient oxygen
Maps Alcohol intoxication
Pathophysiology
Alcohol is metabolized by a normal liver at a rate of about 8 grams of pure ethanol per hour. 8 grams or 10Ã, ml (0.34Ã, USÃ, flÃ, oz) are one standard British unit. An "abnormal" liver with conditions such as hepatitis, cirrhosis, gallbladder disease, and cancer tend to produce a slower metabolic rate.
Ethanol is metabolized to acetaldehyde by alcohol dehydrogenase (ADH), which is found in many tissues, including the gastric mucosa. Acetaldehyde is metabolized into acetate dehydrogenase acetaldehyde (ALDH), which is found primarily in mitochondrial liver. Acetate is used by muscle cells to produce acetyl-CoA using acetyl-CoA synthetase enzyme, and acetyl-CoA is then used in the citric acid cycle.
The acute effect of ethanol is largely due to its central nervous system depression, and depends on the concentration of alcohol in the blood:
- 20-79Ã, mg/dL: Impaired coordination and euphoria
- 80-199 mg/dL - Drinking alcohol: Ataxia, poor judgment, unstable atmosphere. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) defines the term "binge drinking" as a drinking pattern that carries the concentration of alcohol in a person's blood (BAC) to 0.08 g/dL or more.
- 200-299 mg/dL: marked ataxia, slurred speech, poor judgment, unsteady atmosphere, nausea and vomiting
- 300-399 mg/dL: Anesthesia stage 1 ("blackout"), memory deviation, unstable flexibility
- 400 mg/dL: Respiratory failure, coma
As drinking increases, people become drowsy, or faint. After a very high level of consumption, the respiratory system becomes depressed and the person will stop breathing. Patients who are comatose can suck their vomit (causing vomit in the lungs, which can cause "drowning" and then pneumonia if survived). CNS depression and motor coordination disorder along with poor judgment increase the likelihood of unintentional injury. It is estimated that about one third of alcohol-related deaths are due to accidents and 14% are from accidental injuries.
In addition to respiratory failure and accidents caused by effects on the central nervous system, alcohol causes significant metabolic disorders. Hypoglycemia occurs due to inhibition of ethanol gluconeogenesis, especially in children, and can lead to lactic acidosis, ketoacidosis, and acute renal failure. Metabolic acidosis is exacerbated by respiratory failure. The patient may also come with hypothermia.
Mechanism
In the past, alcohol was believed to be a non-specific pharmacological agent that affects many neurotransmitter systems in the brain. However, molecular pharmacology studies show that alcohol has only a few key targets. In some systems, these effects are facilitative and in others inhibitory.
Among the improved neurotransmitter systems are: GABA A , 5-HT 3 receptor agonism (responsible for GABAergic (GABA A PAM receptor ), glycinergic, and cholinergic effects), nicotinic acetylcholine receptors.
Among those inhibited were: NMDA, hydropiridin-sensitive L-type Ca2 and G-protein-activated in improving K-channel.
The result of this direct effect is a further indirect effect wave involving various neurotransmitter systems and other neuropeptides, leading eventually to the behavioral effects or symptoms of alcohol poisoning.
GABA A receptor
Many of the effects of activating GABA receptors A have the same effect as ethanol consumption. Some of these effects include anxiolytic effects, anticonvulsants, sedatives, and hypnosis, cognitive impairment, and absence of motors. The correlation between activating GABA receptors A and the effects of ethanol consumption has led to the study of ethanol and its impact on GABA receptors A . It has been shown that ethanol in fact exhibits a positive allosteric bonding property with GABA receptors A . However, binding is limited to pentamers containing "-subunit rather than" -subsitites. GABA A receptor-containing substituents has been shown to lie outside to the synapse and is involved with tonic inhibition rather than its submiters, which are involved in phasic inhibition. The -subunite has been shown to form an allosteric binding site that makes GABA A receptor-containing substances more sensitive to ethanol concentrations, even to moderate levels of social ethanol consumption (30mM). Meanwhile it has been shown by Santhakumar et al. that recipes of GABA A containing unsubunite-sensitive to ethanol modulation, depending on the subunit combination receptor, may be more or less sensitive to ethanol. It has been shown that GABA recipes A contain both? and? 3-subunit displays increased sensitivity to ethanol. One of the receptors that shows the ethanol insensitivity is? 3-? 6-? GABA A . It has also been shown that the combination of subunits is not the only thing that contributes to the sensitivity of ethanol. The location of GABA receptors A in synapses may also contribute to ethanol sensitivity.
Diagnosis
The exact diagnosis depends on blood tests for alcohol, usually done as part of the toxicology screen. Law enforcement officials in the United States and other countries often use the breathalyzer unit and field serenity tests as an easier and faster alternative to blood tests. There are also various models of breathalyzer units available for consumer use. Since this may have varying reliability and may yield different results than tests used for law enforcement purposes, the results of such devices should be interpreted conservatively.
Many existing informal poisoning tests, which are generally unreliable and are not recommended as a barrier to excessive poisoning or as an indicator of safety of activities such as motor vehicle driving, machine operation, machine tool usage, etc.
To determine if someone is drunk by alcohol in some way other than blood alcohol tests, it is necessary to rule out other conditions such as hypoglycemia, stroke, other alcohol use, mental health problems, and so on. It would be better if his behavior had been observed while the subject was conscious to set the baseline. Some well-known criteria can be used to establish a possible diagnosis. For doctors in acute treatment settings, acute alcohol poisoning may mimic other acute neurologic disorders, or often combined with other recreational drugs that complicate diagnosis and treatment.
Management
Acute alcohol poisoning is a medical emergency because of the risk of death from respiratory depression or aspiration of vomiting if vomiting occurs when the person is unresponsive. Emergency treatments seek to stabilize and maintain adequate open airways and breathing, while waiting for alcohol to be metabolized. This can be done by removing vomitus or, if the person is not conscious or experiencing reflex vomiting disorders, tracheal intubation.
Other sizes may include
- Treat low blood sugar, with an intravenous sugar solution as a low blood sugar induced ethanol that is unresponsive to glucagon.
- Provide thiamine vitamins to prevent Wernicke-Korsakoff syndrome, which can cause seizures (more often a treatment for chronic alcoholism, but in an acute context usually given together to ensure maximum benefit).
- Apply hemodialysis if the blood concentration is very high (& gt; 400 mg/dL), and especially if there is metabolic acidosis.
- Give oxygen therapy as needed through nasal cannula or non-rebreather mask.
- While methoxy drugs can speed up alcohol breakdown, the use of alcohol poisoning requires further study by 2017. It is approved in a number of countries in Europe, as well as India and Brazil.
Additional treatment may be indicated for the treatment of nausea, tremors, and anxiety.
Prognosis
A normal liver detoxifies the blood of an alcohol over a period of time that depends on the initial level and overall physical condition of the patient. An abnormal liver will last longer but still work, provided that alcohol does not cause liver failure.
People who are intoxicated for several days or weeks may experience withdrawal symptoms after acute poisoning has subsided.
A person who consumes alcohol in dangerous quantities can continuously develop an idiosyncratic memory or idiosyncratic toxicity or a pathologic hangover phenomenon.
Excessive consumption of excessive amounts of alcohol can cause liver damage and have other damaging health effects.
Society and culture
Alcohol poisoning is a risk factor in some cases of catastrophic injury, especially for unattended recreational activities. A study in Ontario province based on epidemiological data from 1986, 1989, 1992, and 1995 states that 79.2% of the 2,154 recorded disaster accidents for this study could be prevented, 346 of which involve alcohol consumption. The activities most often associated with alcohol-related catastrophic injuries were snowmobiling 124, fishing 41, diving (40), boating (31) and canoeing (7), swimming (31), driving all-terrain vehicles (24) and cycling (23). These events are often associated with unsupervised young men, often inexperienced in these activities, and many resulting in drowning. Alcohol use is also associated with unsafe sex.
Legal issues
The law of drunkenness varies. In the United States, it is a criminal offense for someone to drink while driving a motor vehicle, except in Wisconsin, where it is only a fine for the first offense. It is also a criminal offense to fly planes or (in some states of America) to assemble or operate amusement park rides while drunk. Similar laws exist in England and most other countries.
In some countries, it is also a violation to present alcohol to people who are already drunk, and, often, alcohol can only be sold by qualified people to responsibly serve through the training of alcohol servers.
The blood alcohol content (BAC) for vehicle legal operations is usually measured as a percentage of the blood volume unit. This percentage ranges from 0.00% in Romania and the United Arab Emirates; 0.05% in Australia, South Africa, Germany, Scotland and New Zealand (but 0.00% for under 20s); to 0.08% in England and Wales, the United States and Canada.
The Federal Aviation Administration of the United States prohibits crew members from performing their duties with a BAC greater than 0.04% within eight hours of consuming alcoholic beverages, or while under the influence of alcohol.
In the United States, Britain and Australia, public intoxication is a crime (also known as "drunk and disordered" or "drunk and unable").
In some countries, there are special facilities, sometimes known as "drunk tanks", for the temporary detention of people found drunk.
Religious view
Some religious groups allow the consumption of alcohol. Some allow consumption but prohibit poisoning, while others prohibit alcohol consumption altogether. Many Christian denominations such as Catholic, Orthodox, and Lutheran use wine as part of the Eucharist and allow drinking alcohol but consider it sin to be drunk.
In the Bible, the book of Proverbs contains chapters that deal with the ill effects of intoxication and warnings to keep away from intoxicating drinks. The Book of Leviticus tells of Nadab and Abihu, the eldest son of Aaron Imam, who was killed for serving in the temple after drinking wine, perhaps while intoxicated. This book continues to discuss the monasticism in which drinking wine is forbidden. The story of Samson in the Book of Judges tells of a bhikkhu from the tribe of Dan who was forbidden to cut his hair and drink wine. Romans 13: 13-14, 1 Corinthians 6: 9-11, Galatians 5: 19-21, and Ephesians 5:18 among other passages that speak against drunkenness. While Proverbs 31: 4, warns that the king and the ruler drink wine and liquor, Proverbs 31: 6-7 promotes the gift of liquor to the perishing and wine to those whose lives are bitter, to forget their poverty and problems.
Some Protestant Christian denominations prohibit drinkers of alcohol based on Bible verses condemning drunkenness, but others allow moderate use of alcohol. In some Christian groups, a small amount of wine is part of the ritual of communion.
At The Church of Jesus Christ of Latter-day Saints, alcohol consumption is forbidden, and teetotalism has become a distinguishing feature of its members. Jehovah's Witnesses allow moderate alcohol consumption among its members.
In the Qur'an, there is a ban on the consumption of alcohol-based alcoholic beverages, and poisoning is considered an abomination in the Hadith. Islamic law schools (Madh'hab) have interpreted this as strictly prohibiting the consumption of all kinds of alcohol and declaring it as haram ("forbidden"), although other uses may be permitted.
In Buddhism, in general, alcohol consumption is not recommended for monks and lay followers. Many Buddhist followers observe the code of behavior known as the Five Precepts, of which the five teachings are attempts to refrain from the consumption of intoxicating substances (except for medical reasons). In the Bodhisattva Oath of Brahma Net Sutra, observed by some monastic communities and some lay followers, the distribution of liquor is also discouraged and consumption.
In the Hindu branch known as Gaudiya Vaishnavism, one of four regulative principles prohibits liquor taking, including alcohol.
In Judaism, according to the biblical attitude to drinking, drinking wine is not permitted to priests and monks. The biblical command to observe the Sabbath and other holidays has been interpreted as having three ceremonial foods which include drinking wine, Kiddush. The Jewish wedding ceremony ended with the bridegroom and the woman drinking a cup of wine together after reading seven blessings, and according to the western "Ashkenazi tradition, after a fast day. But it has become a habit and in many cases even mandated to drink enough to remain calm, and only after the prayer is over.
During the evening Seder on Passover (Pesach) there is an obligation to drink 4 cups of ceremonial wine, while reading Haggadah. It has been assumed as a source for wine-drinking rituals on fellowship in some Christian groups. During Purim there is an obligation to become drunk, though, as with many other decisions, in many communities this is avoided, by allowing sleep during the day to replace it.
In the 1920s due to a new drink law, a rabbi from the Reform Judaism movement proposed using grape juice for ritual instead of wine. Although denied at first, this practice is widely accepted by orthodox Jews as well.
In the Cave of Ancestors in Hebron - The Ibrahimi Mosque as mentioned by Muslims, the ritual of drinking Jewish wine during weddings, the Sabbath and holidays, is the cause of tension with Muslims who do not want to share sites under Israeli authority.
Other animals
In the film Animals are Beautiful People , the whole section is dedicated to showing many different animals including monkeys, elephants, pigs, giraffes, and ostriches, eating overcooked marula fruit causes them to sway and lose. their foothold in a manner similar to a human drunk.
In elephant battles, committed by Greeks during the Maccabean rebellion and by Hannibal during the Punic war, it has been noted that elephants will be given wine before the attack, and only then will they strike forward after feeling uneasy by their driver.
It is a routine practice to give a small amount of beer to a horse race in Ireland. Livestock ruminants have a natural fermentation that occurs in their stomachs, and adding small quantities of alcoholic beverages to their drinks will generally not harm them, and will not cause them to get drunk.
See also
- Serious Night Drink
- Alcohol and sex
- Alcohol flush reaction
- Drive under influence
- In vino verification
- Long-term alcohol effect
- Short-term effects of alcohol
References
Bibliography
External links
- Alcohol Poisoning: NHS Choice
Source of the article : Wikipedia
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