Alcohol Poisoning

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Alcohol (alcohol surrogates) Poisoning
Methanol

Alcohols are a group of chemical substances, which have similar chemical characteristics and toxic (poisonous) effect on human health and life. The group consists of these compounds: ethyl alcohol (C2H5OH), methyl alcohol (CH3OH), propyl alcohol (C3H7OH), ethylene glycol (C2H5(OH)2). Alcohols mentioned above are common in medicine, besides, alcohols can have a lot of isomers. 

Where are Alcohols Used and How do They get into the Human Organism?

Ethyl alcohol (ethanol) – is the most common and well known alcohol; alcoholic beverages contain ethanol. Chronic poisoning is more common (look "Alcoholism") but consuming huge amounts of ethanol may cause coma. 

Methyl alcohol (methanol) is used mostly in industry. It smells and looks pretty much like the usual ethyl alcohol, so people, who drink "moonshine” or buy vodka in unreliable places, are in a risk of methanol poisoning.  

Propyl alcohol (propanol). Its isomers are used more often – isopropyl alcohol is a component of window cleaners, disinfectants, various cleaners, engine liquid and etc.

Ethylene glycol is a derivate of alcohol. It is the main component of engine cooling liquids (antifreeze). Poisoning with this alcohol occurs when a person accidentally consumes some antifreeze. Ethylene glycol is a sweet, sticky fluid, so it can be mistaken for liqueur.

How do Alcohols Affect the Organism?

Human organism has a special enzyme – alcohol dehydrogenase, which breaks most of the alcohols. Unfortunately, after the breakdown, in some cases  poisonous products (metabolites) are formed, which cause coma, nerve damage or even death. 

Metabolites of ethyl alcohol are not very poisonous. When braking down, ethyl alcohol (like other alcohols) consumes water from the cells, uses up glucose and potassium and acidifies the blood (acidosis). These reactions cause so called hangover, and in difficult cases – coma. The treatment of ethyl alcohol coma is the correction of these conditions. 

Methyl alcohol is much more dangerous. Its effects are the same like those of ethyl alcohol, but coma progresses faster, its course is more severe. The metabolites of methyl alcohol damage the eyes, in some cases even causing blindness. 

Ethylene glycol also causes severe coma, also, it affects the kidneys and causes acute renal insufficiency. 

Isopropyl alcohol poisoning is not as severe as other cases mentioned above. Acetone is created during its breakdown, so an important leading sign is acetone smell from the patient's mouth.

How are Alcohol Induced Comas Treated?

Since the cause of alcohol induced comas is the deficiency of water (hypovolemia), glucose (hypoglycemia) and potassium (hypokalemia) as well as acidosis, the main goal of the treatment is simply correcting these syndromes. These methods are appropriate in case of any alcohol poisoning:

  •  Fluid infusions
  •  Glucose infusions
  •  Electrolyte solutions (with potassium and carbonates)

In case of ethyl alcohol poisoning, the coma should be over in 3 – 6 hours, when applying these methods.

In cases of other alcohols poisoning (methyl, propyl, ethylene glycol) the antidote is ethyl alcohol (vodka). It blocks the mentioned-above enzyme (alcohol dehydrogenase), and these alcohols do not break down to their poisonous metabolites. But this method is only effective a short time after the poisoning.

Also, just after the poisoning, the stomach should be cleaned. Besides the methods mentioned above, hemodialysis may also be used to remove the poisonous metabolites. Vitamins, especially group B, and folic acid are also always administered.

   

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