Ethyl Alcohol (Ethanol) Poisoning
The alcohol used daily is ethyl alcohol. Although the use of ethyl alcohol varies according to societies, it is common all over the world. The main problem of alcohol use is secondary injuries. The cause of almost half of motor vehicle accidents is the use of ethyl alcohol. It can also be used for suicidal purposes.
The symptoms seen in alcohol poisoning are basically the accumulation of by-products (metabolites) formed as a result of the breakdown of alcohol in the body.
Ethyl alcohol is excreted mostly by liver, kidney, lungs and respiration. For this reason, those with liver, kidney or lung disease will have excretion problems and metabolite accumulation will increase.
The signs and symptoms of alcohol poisoning vary according to the amount of alcohol consumed, the characteristics of the person (age etc.) and health status. Symptoms may develop more rapidly and more severely at younger ages and in women. Drugs taken with alcohol can also exacerbate alcohol poisoning.
Some patients with chronic alcohol use may develop Wernicke-Korsakoff Syndrome due to thiamine deficiency. Thiamine supplementation is required.
Dose:
Symptoms according to blood alcohol level:
- 20-30 mg/dl motor skills slow down, thinking and judgment ability deteriorates,
- 30-80 mg/dl motor and cognitive problems increase,
- 80-200 mg/dl coordination and judgment disorders, mood lability, cognitive dysfunction,
- 200-300 mg/dl nystagmus, dysarthria, memory disorders,
- 300-400 mg/dl confusion, stupor,
- 400-500 mg/dl coma,
- 500 mg/dl respiratory and circulatory centers are affected, death.
Symptoms:
The signs and symptoms are directly related to the amount of alcohol consumed and the blood ethanol level.
- Nausea, vomiting,
- Stomach ache,
- Sedation,
- Emotional changes,
- Speech disorder,
- Gait disturbance,
- Anxiety,
- Gliding in the eyes,
- Coordination disorder,
- Attention disorder,
- Respiratory distress,
Diagnosis:
A good history and physical examination are required for diagnosis.
In the physical examination, abdominal tenderness, liver and spleen enlargement, heart rhythm, tendon reflexes are evaluated.
The blood ethanol level is checked. If the patient is unconscious, a brain tomography may be required. Complete blood count, biochemical tests are requested.
Treatment:
- The patient’s vital signs are evaluated. If necessary, respiratory support is provided and the vascular access is kept open.
- Secondary injuries, if any, are treated.
- If there is a possibility of intracranial bleeding due to injury or trauma, it is followed.
- Blood glucose level is monitored.
Methyl Alcohol (Methanol) Poisoning (Fake alcohol)
It is used in products such as methyl alcohol paint thinner, antifreeze, glass cleaner. However, it can also be used in the manufacture of counterfeit liquor.
Methyl alcohol turns into formaldehyde and formic acid in the body. Formic acid accumulation is the cause of acidosis. Symptoms of methyl alcohol poisoning occur due to the accumulation of formic acid and formaldehyde.
Poisoning may occur due to consumption of illegally produced alcoholic beverages, accidental intake or use for suicide purposes. Although it is less common than ethyl alcohol poisoning, methyl alcohol poisoning has more serious consequences. Organ failure and death are more common.
Dose:
- It may not cause signs and symptoms in amounts below 20 mg/dL.
- Central nervous system symptoms occur above 20 mg/dL.
- Severe poisoning symptoms and eye problems occur above 40 mg/dL,
- There is a danger of death above 80-100 mg/dL.
Symptoms:
Signs and symptoms appear within an average of 24 hours (40 minutes-72 hours) following methyl alcohol ingestion.
Signs and symptoms usually include:
- Stomach ache,
- nausea, vomiting,
- Visual disturbances (sensitivity to light, blindness, etc.),
- Headache,
- Weakness,
- Unrest,
- Seizures,
- Consciousness disorders,
Diagnosis:
- A good history and physical examination are required for diagnosis.
- The blood methanol level is checked. Blood biochemical tests, electrolyte level follow-ups, blood glucose level are checked.
- An eye examination is done.
- Brain CT may be required.
Treatment:
- The patient’s vital signs are evaluated. If necessary, respiratory support is provided and the vascular access is kept open.
- Blood glucose level is monitored.
- Gastric lavage can be done within the first few hours.
- Supportive treatment is applied.
- Ethyl alcohol or fomepizole are used as antidotes. They prevent the formation of formaldehyde and formic acid.
- In advanced cases, if kidney failure has developed, hemodialysis may be needed.