Professional Documents
Culture Documents
Alcohol Toxicity and Withdrawal Syndrome
Alcohol Toxicity and Withdrawal Syndrome
WITHDRAWAL SYNDROME
03/29/2021
Objective
2
03/29/2021
3 Outline
Introduction
Ethanol
Isopropanol
Methanol
Ethyl Glycol
03/29/2021
4 Introduction
2/3rd of US consume beverages containing ethanol.
Moderate ethanol intake(1-2 drinks/day for men & one drink/day for
women)-appears to reduce the risk of MI.
03/29/2021
7 Cont..
03/29/2021
8 Cont..
Ethanol & isopropanol:
03/29/2021
10 Pathophysiology
Rates of elimination:
03/29/2021
11 Cont..
ADH level: men > women, w/c account higher blood ethanol level
in women.
03/29/2021
12 Cont..
Metabolism of ethanol NAD+ = oxidized form of nicotinamide adenine dinucleotide; NADH = reduced
form of nicotinamide adenine dinucleotide.
03/29/2021
13 Cont..
03/29/2021
14 Cont..
03/29/2021
15 Cont..
03/29/2021
16 Clinical Features
The hallmark of ethanol toxicity is clinical inebriation. Includes:
03/29/2021
17 Severity of ethanol toxicity
03/29/2021
Diagnosis
18
Ethanol
traumatic injuries.
Ethanol levels: required in the pt. with unclear cause, but not
03/29/2021
Treatment
20
syndrome.
03/29/2021
21 Cont..
Wernicke’s encephalopathy is triad of by abnormal mental status,
03/29/2021
22 Cont..
Fluid administration does not hasten alcohol elimination.
recovery.
03/29/2021
23 Isopropanol
03/29/2021
24 Cont..
Isopropanol is ~
03/29/2021
25 Path.
Isopropanol is :
03/29/2021
26 Cont..
The half-life of :
isopropanol is 6 -7 hrs.
03/29/2021
30 Diagnosis
03/29/2021
31 Treatment
Consider hemodialysis:
refractory hypotension
03/29/2021
33 Methanol
Found in:
03/29/2021
34 Cont..
Methanol poisoning occur by ingestion, inhalation or dermal
exposure.
Metabolism of methanol. NAD+ = oxidized form of nicotinamide adenine dinucleotide; NADH = reduced
form of nicotinamide adenine dinucleotide.
03/29/2021
36 Cont..
changes.
03/29/2021
Features of Methanol Toxicity and Treatment
37
03/29/2021
38 Prognosis
correlates with the degree of acidosis, time to presentation, &
initiation of treatment.
Uses as :
Toxicity results from ingestion, b/se the chemical has a low vapor
pressure and does not penetrate skin well.
CNS tissue effects of glycolic acid & calcium oxalate crystals include
cerebral edema, basal ganglia hemorrhagic infarction, &
meningoencephalitis.
03/29/2021
Features of Ethylene Glycol Toxicity and Treatment
45
03/29/2021
46 Indications for Hemodialysis After Methanol or Ethylene Glycol Ingestion
03/29/2021
47 Cont..
03/29/2021
48 Disposition
03/29/2021
Alcohol withdrawal symptoms
49
03/29/2021
50 Clinical features
03/29/2021
51 Cont..
Withdrawal hallucinosis
03/29/2021
54 Cont..
Alcohol-induced Psychotic Disorder
03/29/2021
Clinical Institute Withdrawal Assessment for Alcohol–Revised Scale*
55
03/29/2021
56 Cont..
03/29/2021
57 Cont..
03/29/2021
58 Investigation
Blood drug level
Urine Drug Screen Other studies (if clinically
Blood chemistries indicated)
CBC CX-ray
U/A CT scan
PT/PTT
B12 & folate assays
Amylase /Lipase
59
Treatment
The goals of therapy for alcohol withdrawal are:
03/29/2021
Treatment of Alcohol Withdrawal Syndromes
60
03/29/2021
61 Indications for admission
advanced age
03/29/2021
62 Cont..
03/29/2021
63
Cont..
Discharge Criteria
03/29/2021
65
THANK U!!
03/29/2021