Management of Acute Alcohol Intoxication

MANAGEMENT OF ACUTE ALCOHOL INTOXICATION

Nontolerant individuals who consume alcohol in large quantities develop typical effects of acute sedative-hypnotic drug overdose along with the cardiovascular effects previously described (vasodila-tion, tachycardia) and gastrointestinal irritation. Since tolerance is not absolute, even individuals with chronic alcohol dependence may become severely intoxicated if sufficient alcohol is consumed.

The most important goals in the treatment of acute alcohol intoxication are to prevent severe respiratory depression and aspi-ration of vomitus. Even with very high blood ethanol levels, survival is probable as long as the respiratory and cardiovascular systems can be supported. The average blood alcohol concentration in fatal cases is above 400 mg/dL; however, the lethal dose of alcohol varies because of varying degrees of tolerance.

Electrolyte imbalances often need to be corrected and metabolic alterations may require treatment of hypoglycemia and ketoacido-sis by administration of glucose. Thiamine is given to protect against Wernicke-Korsakoff syndrome. Patients who are dehy-drated and vomiting should also receive electrolyte solutions. If vomiting is severe, large amounts of potassium may be required as long as renal function is normal.