Are You An Alcoholic?: Know Something More About Alcohol

Alcoholic is a primarily a depressant to central nervous system. Following a single dose, peak levels are reached in about one hour, persist for two hours and then decline gradually. After consumption appreciable quantity of alcohol there is release of inhibitions resulting in a state of exhilaration and euphoria. Further doses of alcohol produce progressively, dizziness, slurred speech, ataxia, termors, confusion, nausea, vomiting and increase impairment of mental faculties until stupor and coma supervene. Physical examination at this stage reveals the skin to be hot and flushed or pale and sweating, deep reflexes are exaggerated with bilateral extensor planters, pupils and dilated, breathing is stertorous and pulse is full and bounding. Death occurs uncommonly from respiratory  or circulatory failure.

DIAGNOSIS.

In the presence of a flushed face, semi coma or coma and the odour of alcohol, the diagnosis of alcohol intoxication is easy. However, when confronted with a comatose patient, it is advisable not to ascribe the loss of consciousness to alcohol until all the possibilities have been ruled out by appropriate examination and investigations. When coma persist for more then 24 hours, possibility of mixed poisoning, complicating head injury, subdural haematoma or cerebral stroke should be strongly considered.

MANAGEMENT.

Most of the patients with mild to moderate degree of intoxication usually ‘sleep it off’ and require no special treatment. When stupor or coma has supervened, general principles of management are similar to those described under ‘barbiturate poisoning’. Violent delirium should be controlled with injection chlorpromazine or diazepam but not with barbiturates because of their synergistic effect with alcohol.

The stomach should be emptied and lavaged with tap water to remove unabsorbed alcohol. Administration of insulin and glucose or analeptic drugs is of little practical value. In the presence of deep coma, forced dieresis should be tried.