Indications for Pharmacologic Ethanol Administration
- Ethylene Glycol Intoxication (see Ethylene Glycol, [[Ethylene Glycol]]): competes with
- Mechanism: competes with ethylene glycol for alcohol dehydrogenase (alcohol dehydrogenase enzyme has higher affinity for ethanol and becomes saturated at an ethanol level between 13-30 mg/dL), preventing formation of toxic metabolites
- The half-life of ethylene glycol is prolonged to about 17 hrs in the presence of ethanol infusion
- Methanol Intoxication (see Methanol, [[Methanol]])
- Mechanism: competes with methanol for alcohol dehydrogenase (alcohol dehydrogenase enzyme has higher affinity for ethanol and becomes saturated at an ethanol level between 13-30 mg/dL), preventing formation of toxic metabolites
Administration
Adverse Effects
Neurologic Adverse Effects
Other Adverse Effects
Acute Ethanol Intoxication
Diagnosis
Elevated Osmolal Gap (see Serum Osmolality, [[Serum Osmolality]])
Arterial Blood Gas (ABG)
Ethanol Level
Clinical Manifestations
Neurologic Manifestations
- Ataxia (see Ataxia, [[Ataxia]])
- Delirium (see Delirium, [[Delirium]])
- Loss of Inhibition
Renal Manifestations
Elevated Osmolal Gap with/without Alcoholic Ketoacidosis (AKA) (see Serum Osmolality, [[Serum Osmolality]] and Alcoholic Ketoacidosis, [[Alcoholic Ketoacidosis]])
Other Manifestations
Treatment
Chronic Ethanol Abuse
Gastrointestinal Manifestations
Hematologic Manifestations
- Sideroblastic Anemia (see Anemia, [[Anemia]])
- Thrombocytopenia (see Thrombocytopenia, [[Thrombocytopenia]]): due to impaired platelet production
Neurologic Manifestations
- xxxx (see xxxx, [[]])
- xxxx (see xxxx, [[]])
Other Manifestations
Treatment
Ethanol Withdrawal
Clinical
Treatment
- Benzodiazepines (see Benzodiazepines, [[Benzodiazepines]])
- Chlordiazepoxide (Librium)
- Diazepam (Valium)
- Lorazepam (Ativan)
- Midazolam (Versed)
- Clonidine (see Clonidine, [[Clonidine]]): adjunct to benzodiazepines
- Dexmedetomidine (Precedex) (see Dexmedetomidine, [[Dexmedetomidine]]): adjunct to benzodiazepines
- Decreases benzodiazepine dosing, decreases alcohol withdrawal scoring, and blunts hyperadrenergic cardiovascular responses
References
Ethanol Withdrawal
- Role of α2-agonists in the treatment of acute alcohol withdrawal. Ann Pharmacother. 2011 May;45(5):649-57 [MEDLINE]
- Dexmedetomidine as adjunct treatment for severe alcohol withdrawal in the ICU. Ann Intensive Care. 2012 May 23;2(1):12 [MEDLINE]