scholarly journals Ethanol Infusion for Alcohol Withdrawal Prophylaxis Does Not Cause Intoxication

2016 ◽  
Vol 4 (16) ◽  
pp. 11
Author(s):  
Robert Dillard ◽  
Tanis Welch ◽  
Senan Abdul-Hamed ◽  
Jennifer Kesey ◽  
Sharmila Dissanaike
Keyword(s):  
Serum Sodium ◽  
Alcohol Withdrawal ◽  
Alcohol Intoxication ◽  
Alcohol Withdrawal Syndrome ◽  
High Rate ◽  
Ethanol Level ◽  
Ethanol Infusion ◽  
Benzodiazepine Use ◽  
Average Serum ◽  
Patients Experience

Objective: Alcohol Withdrawal Syndrome (AWS) remains a common problem, especially in trauma and surgical patients. An intravenous ethanol infusion protocol was developed at this institution and previously validated for AWS prophylaxis. One concern with intravenous ethanol has been potential for intoxication and/or side effects. This study was performed on patients receiving AWS prophylaxis with an intravenous ethanol protocol to evaluate for intoxication and the occurrence of any adverse effects. Methods: We did a retrospective review of all patients in our hospital who received AWS prophylaxis by ethanol infusion between 2008 and 2013. Information collected specific to ethanol infusion included rate of administration, serum ethanol levels, serum sodium level, use of benzodiazepines and anti-emetics, and development of AWS. Intoxication was defined using the Texas limit for blood alcohol content in a driver of .08% (80mg/dL).  The study period began at admission and lasted 7 days. Results: Ninety-seven patient charts were reviewed.  Average serum ethanol level on admission was 137 mg/dL. Serum ethanol levels increased in 12% of patients after administration of ethanol infusion, and levels generally decreased over time.  Asymptomatic hyponatremia (serum sodium <135) occurred in 60% of patients. Benzodiazepines were administered to 52 patients (54%); of these, only 15 received increases in infusion rates indicating appropriate protocol use. In addition, 32 of the 52 had the ethanol infusion discontinued prior to scheduled protocol wean. Conclusion: Ethanol infusion for alcohol withdrawal prophylaxis in the hospitalized patient rarely induces alcohol intoxication. However, a majority of patients experience asymptomatic hyponatremia. The high rate of concomitant benzodiazepine use suggests possible low efficacy of the infusion, although low adherence to the protocol could be a contributing factor.

Alcohol intoxication

2018 ◽  
Author(s):  
Satish Keshav ◽  
Palak Trivedi
Keyword(s):  
Alcohol Abuse ◽  
Alcohol Withdrawal ◽  
Physical Dependence ◽  
Alcohol Intoxication ◽  
Delirium Tremens ◽  
Alcohol Withdrawal Syndrome ◽  
Altered Mental Status ◽  
Severe Form ◽  
Alcoholic Beverages ◽  
Broad Term

Alcohol intoxication occurs when the quantity of alcohol (ethanol) consumed exceeds one’s tolerance for the substance, with consequent impairment of the individual’s mental and physical functional status. Alcohol abuse is a broad term for general ill health (mental, social, and/or physical) resulting from the repetitive, compulsive, and uncontrolled consumption of alcoholic beverages. Manifestations of alcohol abuse include a failure to fulfil one’s responsibilities, resulting in loss of employment, personal relationships, or finances. Alcohol dependence is a condition which arises as a result of alcohol abuse and occurs when an individual continually uses alcohol despite significant areas of dysfunction, with evidence of physical dependence.Alcohol withdrawal syndrome is the set of symptoms and physical signs observed when an individual reduces or abruptly stops alcohol consumption after prolonged periods of excessive intake; it is largely due to the development of a ‘hyperexcitable’ central nervous system. Delirium tremens is the most severe form of alcohol withdrawal; it manifests as altered mental status, hallucinations, and sympathetic overdrive, which may progress to cardiovascular collapse if left untreated.

Mesoridazine and Chlorpromazine in the Treatment of Alcohol Withdrawal Syndrome

1973 ◽  
Vol 18 (5) ◽  
pp. 385-387
Author(s):  
J.B. Frost
Keyword(s):  
Side Effects ◽  
Alcohol Withdrawal ◽  
Withdrawal Syndrome ◽  
Alcohol Intoxication ◽  
Alcohol Withdrawal Syndrome ◽  
Acute Alcohol Intoxication ◽  
Double Blind ◽  
Therapeutic Regime ◽  
Significant Difference

Forty patients admitted for the treatment of alcohol withdrawal were placed on either chlorpromazine or mesoridazine on a double-blind basis. No significant difference in rate or degree of improvement between the two groups was noted and both groups showed an improvement which was more marked in the first week of treatment. There were few significant side effects from either drug. Improvement on either therapeutic regime is predictable and both are effective in relieving or lessening agitation, tremulousness, hallucinations and anxiety in patients recovering from acute alcohol intoxication.

scholarly journals Impact of Adjuvant Anticonvulsant Medications on Benzodiazepine Use and Delirium in Alcohol Withdrawal Syndrome

2021 ◽  
Vol 23 (5) ◽  
Author(s):  
Farshid Fargahi ◽  
Ritesh Shrestha ◽  
Himanshu Rawal ◽  
Bernard G. Jaar ◽  
Allison A. Chilipko ◽  
...  
Keyword(s):  
Alcohol Withdrawal ◽  
Withdrawal Syndrome ◽  
Alcohol Withdrawal Syndrome ◽  
Benzodiazepine Use

Chronopharmacology of alcoholism

2021 ◽  
Author(s):  
Е.В. Филиппова ◽  
Ю.К. Кондрашова ◽  
Ю.Ш. Тагоев
Keyword(s):  
Alcohol Withdrawal ◽  
Withdrawal Syndrome ◽  
Alcohol Intoxication ◽  
Clinical Manifestations ◽  
Alcohol Withdrawal Syndrome ◽  
Integrated Approach ◽  
Individual Characteristics ◽  
Wide Range ◽  
The Individual ◽  
Fear And Anxiety

В статье представлен анализ информации из литературных источников, посвященной изучению хронофармакологии алкоголизма. Для лечения алкоголизма используется комплексный подход, определяющийся тяжестью состояния больного и индивидуальными особенностями симптоматики. В связи со способностью фармакологических соединений вмешиваться в течение ритмических процессов на всех уровнях организации биосистемы хронофармакологический эффект лекарственных средств может быть полезным или нежелательным. Высокой степенью осложнений со стороны сердечно-сосудистой и нервной систем, а также печени и желудочно-кишечного тракта характеризуется хроническая алкогольная интоксикация. Надежного средства патогенетической фармакотерапии алкоголизма до настоящего времени не разработано. При этом лекарственные препараты используют в основном для купирования явлений абстиненции. Одно из первых мест в терапии алкогольного абстинентного синдрома, сопровождающегося тревогой, страхом и беспокойством, занимают депримирующие средства. Однако расширение их применения в Российской Федерации для лечения алкоголизма остается необоснованным. Так как алкоголизм вызывает крайне разнообразные по своим клиническим проявлениям и по степени тяжести психические расстройства, то для их лечения используется широкий спектр психотропных препаратов. Для проведения противогипоксической и детоксифицирующей терапии используются энергокорригирующие средства. Алкогольный абстинентный синдром с преобладанием неврозоподобных и вегетативнососудистых расстройств является показанием к применению препаратов из класса антиоксидантов. Они сочетают в себе свойства транквилизаторов и ноотропов, не оказывая токсического воздействия на сердце и защищая миокард в условиях гипоксии. Однако на данный момент существует дефицит информации об эффективности их применения при алкогольной абстиненции. The article presents an analysis of information from literary sources devoted to the study of the chronopharmacology of alcoholism. For the treatment of alcoholism, an integrated approach is used, which is determined by the severity of the patient's condition and the individual characteristics of the symptoms. Due to the ability of pharmacological compounds to interfere during rhythmic processes at all levels of the organization of the biosystem, the chronopharmacological effect of drugs may be useful or undesirable. Chronic alcohol intoxication is characterized by a high degree of complications from the cardiovascular, nervous systems, liver and gastrointestinal tract. A reliable means of pathogenetic pharmacotherapy of alcoholism has not yet been developed. At the same time, medications are used mainly for the relief of withdrawal symptoms. One of the first places in the treatment of alcohol withdrawal syndrome, accompanied by anxiety, fear and anxiety, is occupied by depressants. However, the expansion of their use in the Russian Federation for the treatment of alcoholism remains unfounded. Since alcoholism causes extremely diverse mental disorders in their clinical manifestations and severity, a wide range of psychotropic drugs is used for their treatment. For antihypoxic and detoxifying therapy, energy-correcting agents are also used. Alcohol withdrawal syndrome with a predominance of neurosis-like and vegetative-vascular disorders is an indication for the use of drugs from the class of antioxidants. They combine the properties of tranquilizers and nootropics, without having a toxic effect on the heart and protecting the myocardium in hypoxia. However, at the moment there is a lack of information about the effectiveness of their use in alcohol withdrawal.

scholarly journals Relations of CYP2C19*2 genetic polymorphisms to plasma and saliva concentrations of diazepam in patients hospitalized for alcohol withdrawal

2021 ◽  
Vol 1 (1) ◽  
pp. 84-92
Author(s):  
V. Yu. Skryabin ◽  
M. S. Zastrozhin ◽  
E. A. Grishina ◽  
K. A. Ryzhikova ◽  
V. V. Shipitsyn ◽  
...  
Keyword(s):  
Genetic Polymorphisms ◽  
Alcohol Withdrawal ◽  
Alcohol Withdrawal Syndrome ◽  
Therapeutic Drug ◽  
Efficacy And Safety ◽  
Psychometric Scales ◽  
Male Patients ◽  
Polymerase Chain ◽  
Patients Experience ◽  
Dose Dependent

Diazepam is one of the most widely prescribed tranquilizers for the therapy of alcohol withdrawal syndrome (AWS). However, diazepam therapy often turns out to be ineffective, and some patients experience dose-dependent adverse drug reactions. Previous studies have shown that the metabolism of diazepam involves the CYP2C19 isoenzyme, whose activity is highly dependent on polymorphism of the encoding gene. The objective of our study was to investigate the effects of CYP2C19*2 genetic polymorphisms on plasma and saliva concentrations of diazepam as well as its impact on the efficacy and safety rates of therapy in patients with AWS. The study was conducted on 100 Russian male patients with AWS who received diazepam in injections at a dosage of 30.0 mg/day for 5 days. Genotyping was performed by real-time polymerase chain reaction. The efficacy and safety assessment was performed using psychometric scales. We revealed differences in the efficacy and safety of therapy in patients with different CYP2C19 681G>A genotypes. Therapeutic drug monitoring (TDM) revealed the statistically significant differences in the levels of diazepam plasma concentration: (GG) 199.83 [82.92; 250.58] vs (GA+AA) 313.47 [288.99; 468.33], p=0.040, and diazepam saliva concentration: (GG) 2.80 [0.73; 3.80] vs (GA+AA) 5.33 [5.14; 6.00], p=0.003).

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