Ethanol Toxicity Toxicology 4th lab Dr. Ansam jalal Prepared by : Shamil Naseh Suren Azad Saya Amir

Ethanol toxicity Ethanol is two carbon chain alcohol. The leading cause of morbidity across cultures. Is the most common psychoactive drug used by children , adolescent , and adults.

Pathophysiology Ethanol is readily and rapidly absorbed and distributed through the body. The primary route of absorption is oral, inhalation and even percutaneously. PPC occur after 30-60 min after ingestion Co ingestion with food will affect the absorption It metabolized in liver by ADH to acetaldehyde then it further break down to acetic acid by aldehyde dehydrogenase.

Mechanism of toxicity It binds directly to Gamma-aminobuteryc acid (GABA) receptor in the CNS and cause sedative effects similar to those of benzodiazipines. It also block the N-methyl-D-aspartate (NMDA) glutamate receptor It has direct effect on cardiac muscle , thyroid and liver.

Acute ethanol toxicity can cause: CNS depression Mild vasodilation can cause decrease in blood pressure Flushed skin Urticaria Inhibition of spermatogenesis Hypothermia Tachycardia Myocardial depression

Acute ethanol toxicity can cause: Variable papillary response Respiratory deprerssion Decrease sensitivity to airway foreign body Diuresis Hypoglycemia <50 mg/dL

High dose of ethanol can cause : ataxia, slurred speech Acute pancreratitis Liver cirrosis Sever myocardial depression Hypotension Atrial fibrillation Lactic acidosis CHF Sudden death

Treatment Hypoglycemia and respiratory depression are the most 2 immediate life threatening conditions. Access the airways and secure it with endotracheal tube if the patient is not maintaining good ventilation Mechanical ventilation Replace fluid by IV Ensure normal body temperature

Treatment Correct hypoglycemia In children 2-3 ml/kg of 25% dextrose solution And electrolyte replacement If acute after 1 hr Nasogastric tube and evacuating the stomach contents If chronic give thiamine 100mg IV or IM

Treatment GABA antagonist eg:naloxone Diuretic is not helpful Charcoal is not recommended Fructose infusion but with monitoring Dialysis but with monitoring