Alcohol poisoning

Alcohols are a vast class of organic compounds that have a large distribution in nature and industry. Some of them are physiologically present in living organisms and perform vital functions, others are obtained by humans as a result of specially organized chemical reactions. Not all alcohols are equally safe for humans, and even those that participate in physiological processes (endogenous alcohol, mainly ethanol), in large doses can cause irreparable harm. Given the prevalence of alcohols, and especially ethanol, in our lives, it is not surprising that alcohol poisoning has become such an everyday problem that it is no longer a surprise to anyone. [1]

Alcohols in our lives

Most often, when it comes to alcohol or poisoning with this caustic substance, one immediately thinks of the well-known and much-loved alcohol, which is most often consumed internally, but less often used for disinfecting the skin and wounds, for compresses, etc. Certified alcohol sold in stores and so-called moonshine contain ethanol, which is exactly what causes intoxication. Certified alcohol sold in stores and so-called moonshine contain ethanol, which causes intoxication.

Ethanol can be called a relatively safe alcohol because this substance is not foreign to the body. Yes, C2H5OH can be found in the body of every person. One part of it is produced by cells to exchange energy with intercellular fluid, the other part is the result of a chemical reaction during digestion of carbohydrate food (fermentation in the intestine).

But scientists have found out that the content of endogenous alcohol in the blood is no more than 1 ml per 1 liter of blood. In such a concentration we simply do not feel it, nor do the devices for measuring the ethyl alcohol content in the blood show it. In order to relax and experience a sense of euphoria, people ingest endogenous alcohol (ethanol supplied to the body from the outside). As the concentration of ethanol in the blood increases, changes in human behavior, impaired coordination of movement, decreased attention span, etc. Appear. As ethanol accumulates in the brain, it begins to affect mental processes: a person's intellectual abilities, control of his/her actions, awareness of self and surroundings.

Exogenous alcohol in high concentrations has a pronounced toxic effect on individual organs and the whole organism. Often it leads to the death of a person. According to WHO statistics, more than 6% of men and 1% of women die annually as a result of alcohol poisoning (acute or chronic).

In addition to ethyl alcohol used in the food industry, there is also technical alcohol, which has a higher concentration. A standard bottle of vodka contains 40% alcohol, while a concentrated solution has about 92% ethanol (medical alcohol is 96%). Consumption of undiluted concentrated alcohol, even in small concentrations, can cause mucous membrane burns, not to mention the strongest toxic effects on the body. A person without medical assistance can die from acute alcohol poisoning even though this substance is close to our physiology.

But there are not so many people willing to drink pure alcohol, so alcohol poisoning is more often caused by so-called surrogates. For example, the addition of another representative of alcohols - methanol - to alcoholic beverages practically does not affect their taste, but can cause sad consequences for those who will drink this surrogate. Another name of methanol - wood alcohol - it received because the raw material for its production was previously wood.

Methanol (CH3OH) is not used in the food industry, it is a purely technical alcohol used in the chemical industry (more often as a solvent or degreaser). Most often we deal with denatured alcohol (methanol to which other substances have been added that are dangerous for the organism when consumed orally and not infrequently also when inhaled).

For the body, methyl alcohol is a foreign substance, a poison, because the products of its metabolism are very toxic. In small concentrations methanol causes severe intoxication (poisoning), in increased concentrations - death (100 ml of methanol is fatal for a person, for "pure" ethanol this figure is 300 ml and more). Even small doses of methanol are capable after 2-3 days to cause noticeable visual disturbances, loss of consciousness and other manifestations of permissive effects on the body.

Ammonia (NH3 x H2O or NH4OH), a 10% aqueous solution of ammonia, ammonium hydroxide, is a liquid with a specific odor. It is difficult to confuse it with another representative of the class of alcohols. Ammonia is used for medical and household purposes.

As a rule, it is not used internally, except to induce vomiting (often in alcohol poisoning), but in diluted form (no more than 10 drops per 100 ml). In its pure form, the substance causes burns of the esophagus and stomach, and in large concentrations (10-15 mg) even death. By the way, inhalation of vapors of concentrated ammonia can cause reflexive respiratory arrest, so it is not used for resuscitation, if the patient is conscious.

Propanol, aka isopropyl alcohol or IPA (chemical formula - CH3CH(OH)CH3), is another volatile transparent organic substance with a pungent odor. It is a technical alcohol. It is actively used as a solvent, preservative (in non-food industry and household) and antiseptic (in medicine). IPS is a raw material for the production of hydrogen peroxide and acetone. It is used as a substitute for ethyl alcohol in cosmetics, household and automobile chemistry, and medicine. It also has many specific applications in pharmacology, turning, milling, welding.

High toxicity of the substance (3.5-4 times more toxic than ethanol) does not allow its oral use. IPS is less volatile and does not accumulate in the body, so poisoning by inhalation is practically excluded. But when alcohol is used orally, it is quite possible, but, statistically speaking, this happens very rarely and most often with small children who try to taste everything.

Fatal alcohol poisoning also belongs to the category of exceptions. The fact is that due to its high toxicity and transformations inside the body, IPA quickly induces intoxication, which does not allow the drinker to take a lethal dose on his own. Despite the fact that already 50 ml of isopropyl alcohol causes a noticeable toxic effect on the body, a dose almost 10 times higher than the toxic dose can be fatal.

Formyl alcohol is familiar to us due to its use in medicine. But it is also used as a solvent in chemical reactions. It can be present as a surrogate in alcoholic beverages. It is a solution in concentrated ethanol (more often 70%, less often 96%) of formic acid (HCOOH), as well as boric alcohol is a solution of boric acid, and salicylic alcohol is a solution of salicylic acid.

In medicine, formyl alcohol is used externally and does not harm the body, having a local "distracting" effect in pain of various types. Alcohol poisoning is possible only when consumed internally (usually as part of uncertified alcoholic beverages). Formyl alcohol acts similarly to methanol (so it is categorized as a poison), plus it causes irreversible kidney damage.

The use of ethanol substitutes in alcoholic beverages often causes mass alcohol poisoning. One such tragedy was the methyl alcohol poisoning in western Estonia in 2002, which caused death and disability for more than 100 people. Due to inadequate use of alcohol-containing liquids containing methanol, more than 120 people were injured in Irkutsk in 2016, 78 of them lost their lives. [2]

Causes of the alcohol poisoning

Despite the fact that we encounter alcohols quite often in our lives, accidental poisoning of adults is virtually impossible unless it is a pre-planned crime. All alcohols have a distinct taste and odor, so it is simply impossible to confuse them with other liquids consumed for food.

The probability of poisoning by inhalation of alcohol vapors is much lower than by ingestion of caustic liquid. The latter happens either due to carelessness or ignorance (most often children), or because of carelessness, observed against the background of alcohol addiction.

Ethanol poisoning most often occurs as a result of an incorrectly calculated dose of drink. If a person has no intolerance to alcohol, then one sip or even a shot of high-quality vodka can not cause poisoning. The dose at which symptoms of intoxication appear is different for each person, and it depends on the state of health, the presence of chronic diseases, weight, practice and years of drinking.

It is important to take into account that we are talking about alcohol-containing drinks, not pure alcohol, which in undiluted form can cause burns and severe intoxication even in small doses.

Alcohol consumption alone is not a cause of poisoning. Moderate consumption of licensed alcoholic beverages is more likely to cause liver and other organ diseases than serious poisoning. But it is one of the major risk factors. Given the annual rise in the price of quality alcohol, it's not surprising that people who are alcohol dependent or planning a party often favor more affordable spirits. But goods without excise stamps often have questionable quality along with an affordable price. Without knowing exactly what impurities cheap alcohol contains (and the manufacturer will certainly keep this information secret), you can easily get poisoned by drinking even much less than the usual norm.

But "fallen" alcohol quite often contains methyl alcohol, which is cheaper than ethanol and practically indistinguishable in color, taste and smell. Producers of such goods pursue only the goal of profit (the cheaper the raw materials, the more you can earn on the final product, which tastes no different from the original), not caring about the health of others. Widespread distribution of such products leads to mass poisoning with alcohol. So it turns out that if you are afraid of getting poisoned, don't drink or buy alcohol in trusted outlets where there is strict quality control of goods.

The behavior of people suffering from alcohol addiction sometimes defies all logic. It is not surprising that many of them, as they say, drink anything that burns. This includes not only alcoholic beverages, but also medical alcohol, alcohol-containing medicinal tinctures, and sometimes even household liquids (denatured alcohol). In the absence of funds for quality alcohol, all this replaces it, causing severe poisoning, burns of the digestive tract mucosa, malfunctions of various organs.

Alcohol poisoning in children is most often the result of curiosity (desire to taste everything) or the desire to quench thirst. Alcohol in appearance is almost indistinguishable from water, because the child can easily be poisoned by it, given that his weight needs a very small dose to intoxication (not for nothing doctors do not recommend using alcohol to treat children even externally). If such "water" is not ethyl alcohol, but, for example, ethanol or IPA, the result can be deplorable.

Technical alcohol is actively used in industry as a popular raw material for the production of various technical, chemical and household liquids. A person without addiction is unlikely to take such liquids internally. But working at enterprises one can easily be poisoned by poisonous alcohol vapors in case of their leakage from storage tanks, poor ventilation of workshops, ignoring the requirements of labor protection (for example, many people do not want to wear respirators and protective masks).

The use of windshield wipers containing toxic alcohols is also considered a risk factor for intoxication. These liquids should not be sprayed in poorly ventilated areas, as inhalation of alcohol vapors may cause symptoms of poisoning. [3]

Pathogenesis

The pathogenesis of alcohol poisoning is that, entering the body in one of the possible ways, the toxic substance penetrates the blood and is spread by it throughout the body. Even small doses of ethanol cause disturbances in the CNS, which is felt in the form of dizziness, unreasonable euphoria, impaired coordination of movements and balance. Accumulating in brain tissue, it causes more serious disorders (memory, thinking, attention problems, inadequate behavior, degradation). Other organs suffer from the toxic and irritating effect of alcohol: liver, heart, kidneys, endocrine system.

At high doses of alcohol, symptoms appear after a short period of time. With regular use of moderate and low doses, poisoning occurs gradually, becoming chronic. Acute symptoms appear when the concentration of ethanol in the CNS reaches critical values. In the case of methanol or other technical alcohol, acute poisoning occurs even at low doses.

Symptoms of the alcohol poisoning

Alcohols are organic compounds of the same class, differing in the number of hydroxyl groups and the strength of toxic effect on the human body. Ethyl alcohol is considered to be the least toxic, which makes it possible to use it in food (mainly in diluted form) and pharmacological industry. But in large doses and with regular use of alcohol poisoning cannot be avoided.

Methyl alcohol, IPA and other technical alcohols, as well as the combination of alcohols with acids (in pharmacology) are more toxic to the body, so that symptoms of acute poisoning appear even when small doses are consumed. Nevertheless, it is the earlier or later appearance of symptoms that is at issue, not the difference in clinical picture.

Regardless of the type of alcohol, the first signs of poisoning are:

• nausea and vomiting (when taking concentrated liquids - burning and pain in the esophagus and stomach), diarrhea may occur in case of stomach weakness, although this symptom is not specific for such poisonings,
• CNS symptoms: headaches and dizziness, flickering of flies, loss or confusion, irritability and aggression, apathy,
• cardiovascular system: increase in BP (later it may fall sharply), increased pulse rate (palpitations), shortness of breath,

If we talk about poisoning with high-quality ethyl alcohol, the clinical picture will depend on the degree of intoxication. Symptoms of intoxication appear already at the stage of light intoxication (violation of control over the volume of speech, violation of the character of movements, change in the character of thinking and mood indicate the effect of alcohol on the CNS, and reddening of the skin and increased heart rate indicate changes in the cardiovascular system). But all these manifestations of the toxic effects of alcohol on the body gradually pass on their own, if the dose of alcohol is not increased.

The next stage (intoxication of medium severity) is characterized by more gross changes in behavior, difficulty in switching attention, peculiarity of thinking, and a few hours later the first symptoms of poisoning appear: dry mouth, thirst, discomfort in the stomach, unpleasant sensations in the heart and liver, there may be headaches, a feeling of brokenness

In severe intoxication, speech (it becomes incomprehensible, incoherent) and balance disorders are noticeable, a state of stunnedness appears. A person is at first overexcited with increased sexual desire, and then comes a period of drowsiness, apathy. A person not hardened in drinking alcoholic beverages after a while (usually morning) can wait for the appearance of nausea, vomiting, excruciating headaches, the feeling that you turn inside out - signs of a hangover or withdrawal syndrome, indicating alcohol poisoning.

The fourth stage is severe intoxication or acute poisoning with ethyl alcohol, accompanied by the appearance of serious disorders, up to alcoholic coma, heart rhythm disturbances, seizures, loss of control over acts of urination and defecation, severe vomiting with the danger of vomit entering the respiratory tract, memory loss. Death is not uncommon.

It is clear that when using low-quality alcohol and technical alcohol, poisoning will develop according to a different scheme, although the bulk of the symptoms remain unchanged. [4]

Clinical picture of poisoning by technical types of alcohol

Symptomatology of poisoning with different types of alcohol has a lot in common, and, nevertheless, the development of the pathological process in each case has its own characteristics. And if we are not talking about pure alcohol, but denatured or combined composition, then there may also appear nonspecific symptoms due to the action of not only alcohol as a poison, but additional components.

Since we have already discussed in detail the symptoms of poisoning with ethyl alcohol used in the food industry, it remains to pay attention to those alcohols that are used in industry and household (industrial alcohol). This can include crude ethanol, methyl and isopropyl alcohol. Poisoning with industrial alcohol has a more severe clinical picture with failures in the work of many organs and systems. Thus, the symptom complex of poisoning with industrial alcohol and alcohol surrogates contains a huge list of unpleasant manifestations:

• Dyspeptic disorders: pain in the stomach and in the liver region on the right side, nausea, vomiting, diarrhea. But if the discomfort in the digestive system is associated with the irritating effect of alcohol on the mucosa, vomiting is already a central reaction caused by the effect of poison on the CNS (excites the vomiting center).
• Neurological disorders: headaches and dizziness, impaired coordination of movements and balance, agitation and apathy, feelings of euphoria, slurred speech, hallucinations, delirium.
• Cognitive disorders: problems with memory, attention, illogical thinking.
• Violations of the emotional-volitional sphere: reduced control over their behavior, immorality, mental degradation and loss of human appearance.
• Cardiovascular system disorders: hyperemia of the face combined with cyanosis of other skin areas, rapid pulse, increase, spikes or drop in blood pressure. In severe poisoning, BP may rise and mucous membranes remain cyanotic.
• Autonomic dysfunction: hyperhidrosis, hypersalivation (salivation), fluctuations in body temperature, chills, sexual dysfunction.
• Visual and hearing impairment (decreased visual acuity, up to complete loss of vision, blurred vision, flickering of flies, double vision, feeling stunned).
• Respiratory disorders: dyspnea associated with hypoxia, frequent and noisy breathing caused by irritation of the respiratory center and pulmonary edema. Problems can also be caused by vomit entering the respiratory tract when the drinker is semi-conscious.
• Disorder of the excretory system: increase in the amount of urine and frequency of urination (increased diuresis), but in severe poisoning the situation is reversed, up to the cessation of urine production by the kidneys. Loss of control over the acts of urination and defecation.
• Convulsive syndrome in severe poisoning (is a manifestation of hypoxia, cerebral edema or the effect of poisons on the CNS).
• Motor disorders: the presence of unwarranted accompanying movements, alternating states of euphoria, excitement and apathy, relaxation, decreased muscle tone.
• Suppression of conditioned reflexes.
• Disturbance of consciousness: a person may fall into a stupor, be in a comatose state due to collapse (a sharp drop in BP), alcoholics are often marked by mental confusion and delirium.
• Yellow tint of the skin and sclerae (a clear sign of toxic effects on the liver, as a result of which its performance is impaired).

Conventionally, alcohol poisoning has in its clinical picture 2 stages: toxicogenic and somatogenic. The first is due to the toxic effect of alcohols and is manifested by symptoms of intoxication of the body. The second shows what functional disorders on the part of organs and systems causes the poison that has entered the body.

But different poisons have different properties, so their effect on the human body is different. For example, poisoning with isopropyl alcohol is much easier than with methyl alcohol, despite its high toxicity. The pronounced narcotic effect of IPA does not allow an adult to independently take a critical dose. Therefore, a person, quickly reaching the state of alcoholic trance, is simply unable to drink a dose that could lead to death, and in low doses this alcohol does not cause serious health problems.

But for children and people weakened by disease, IPS can be dangerous, because they are enough and small doses to feel the symptoms of poisoning:

• Vomiting and diarrhea, sometimes with flecks of blood due to the strong irritant action on the esophagus and stomach.
• Soreness in the epigastrium, muscles and even the whole body.
• Severe migraine-like headaches and dizziness.
• Increased excitability and motor activity.

These are the first signs of poisoning, which appear within half an hour. In severe intoxication, the clinical picture is similar to severe alcohol poisoning: slurred speech, impaired coordination of movements (ataxia), respiratory distress, drop in BP, coma, death. [5]

Methyl alcohol poisoning is severe in people of different ages. But most often it affects young and middle-aged people after drinking alcoholic surrogates. [6]

The first signs of wood alcohol poisoning are considered to be:

• Nausea and vomiting, epigastric pain.
• Head pain, dizziness, dizziness, flies before the eyes, feeling stunned, hypersalivation.
• Agitation, aggression.
• Frequent pulse (tachycardia), increasing and then falling BP, the appearance of shortness of breath.

Most symptoms are due to the effects of methanol metabolites (converted to formic acid and formaldehyde in the body).

After 1-2 days, later and more serious symptoms appear:

• Lower extremity pain.
• Progressive visual impairment.
• Severe headaches.
• Confusion and loss of consciousness.
• Coma.

When low doses are consumed, a person may fall into a superficial alcoholic coma characterized by: hiccups, urges to vomit, floating eye movements, involuntary urination, cold wet skin, and lack of verbal communication.

Consumption of large doses of methanol causes acute poisoning without a latent period. Symptoms appear almost immediately and in full. In severe poisoning, a person may fall into a deep coma. Its manifestations are considered: dilated pupils, lack of sensitivity to pain, respiratory disorders, convulsions, frequent pulse, swelling of the eyelids, marble color of the skin.

Methanol is only one of the unlicensed additives to alcohol. The "palyenka" may contain other dangerous substances that affect the body in their own way, which causes the appearance of atypical symptoms that make it difficult to diagnose alcohol poisoning. For example, the use of untreated ethyl alcohol with impurities (technical or hydrolyzed ethyl alcohol contains acetaldehyde, amyl and butyl alcohols, methanol) can cause severe poisoning with fatal outcome even in small doses.

One of the popular technical alcohols is ethylene glycol (C2H6O2) - a transparent sweetish oily liquid without odor, used in antifreeze, brake fluids, heating systems and cars (as a coolant), computers (cooling systems), in the production of many polymers, as a paint solvent, in shoe creams, etc.

Antifreeze - liquid for radiators - is especially attractive for people with alcohol addiction, because when it is consumed inside there is a state similar to alcohol intoxication. However, afterwards a person most often gets severe and often fatal alcohol poisoning.

Initially, the clinical picture is similar to that of alcohol poisoning. Patients are characterized by excitement and euphoria. During 1-12 hours and more the patient does not experience any unpleasant sensations (at this time he can fall asleep and wake up with signs of hangover), after which there is a period of signs of CNS disorders (headache, nausea, vomiting, thirst, abdominal pain, weakness), followed by symptoms of kidney and liver. In case of mild poisoning (30-60 ml of ethylene glycol), severe kidney damage does not occur, change of urine character is possible.

Poisoning of medium severity is manifested by a shorter latent period (up to 8 hours), pronounced toxic effects on the brain, decreased urine output, but without severe irreversible consequences.

The latent period in severe poisoning is shortened to 5 hours or is absent at all, characterized by the development of acute renal failure, prone to progression. At the same time, symptoms on the part of the CNS may be absent or may be expressed implicitly.

The lethal dose of ethylene glycol varies from 50 to 500 ml, but most often we are talking about doses in the range of 100-300 ml. Both alcohol itself and its metabolites are highly toxic.

But poisoning due to inhalation of ethylene glycol vapors is practically excluded due to low volatility of the substance. In chronic inhalation intoxication with high doses, there may be changes in blood composition, autonomic reactions (more often lowering of blood pressure), irritation of eyes and respiratory system, drowsiness, visual disturbances, less often loss of consciousness.

Poisoning by alcohol-containing medicines

Naphtha and formyl alcohol are classified as medicines, although they have a wider application in everyday life. These are preparations based on pure ethyl alcohol (without additives typical of technical alcohols), used mainly externally. Nashatyr, although it can be used internally to provoke vomiting, but in strictly limited doses.

Poisoning with ammonia alcohol is possible with ingestion of large doses of undiluted ammonia solution, which not everyone will dare to do, given the poisonous repulsive odor of the drug. But if this happens, it is important to pay attention to the appearance of such symptoms caused by irritation of mucous membrane receptors:

• Severe spasmodic stomach pain, nausea, vomiting, diarrhea, which is accompanied between defecations by cutting, clenching pain in the intestines.
• Burning of the mucous membranes of the mouth, throat and nose, hypersalivation (severe uncontrollable salivation).
• Respiratory disorders, cough, runny nose, swelling of the larynx with difficulty in inhaling and swallowing.
• Agitated state, increased motor activity along with movement discoordination,.
• A sharp rise in temperature, reddening of the skin, the appearance of large and small spots on it.
• Sudden increase in BP followed by its fall, collapse, convulsions, fainting, loss of consciousness.

Poisoning can also be caused by prolonged inhalation of ammonia vapors, not without reason doctors do not recommend that a person inhale it for more than 2-3 seconds. But in this case the symptoms will be somewhat different:

• Dizziness and nausea.
• Dry lips and mouth.
• A feeling of pressure in the chest.
• Blurred vision, difficulty focusing your eyes on objects.
• Hallucinations, hyperexcitability.
• Interrupted speech.
• Feeling hot in the head (hot flashes).

These are all signs of impaired cerebral circulation that cannot be ignored.

Formyl alcohol is a medicine used locally for rubbing painful areas in neuralgia, myositis, arthralgia. That is, it is a medicine for pain, the effect of which is due to two components. Ethyl alcohol (and it is 70% in the drug) stimulates blood circulation, improves tissue trophicity, has a warming effect, reducing pain. Formic acid has a local irritant and distracting effect, effectively affecting skin receptors, stimulating the production of substances in the body that reduce sensitivity to pain.

Formic acid is a substance with a pronounced irritant effect, which in contact with mucous membranes causes severe pain, burning and burns. It is also a rather toxic substance (just remember what is associated with the toxic effects on the body of methanol, one of the metabolites of which is formic acid). Nevertheless, the presence of ethanol in the liquid is attractive to drinkers who do not think about the consequences. The effects of formic alcohol on the body are similar to methanol.

Ant alcohol poison ing is one of the types of denaturedalcohol poisoning, which proceeds in a severe form with pronounced disorders of the CNS and various organs (heart and circulatory system, kidneys, liver). Its symptoms resemble methyl alcohol poisoning: nausea, vomiting, abdominal pain, followed a day later by headache, leg muscle pain, double vision, visual disturbances, up to blindness, convulsions, agitation, heart rhythm disturbances. Blood pressure drops sharply, collapse occurs, at high doses - coma and respiratory arrest. In the absence of assistance, the patient is threatened with deep coma and death from respiratory paralysis.

Thus, the words "alcohol" and "spirit" cannot be considered synonymous. Quality alcohol contains purified ethyl alcohol without dangerous additives. In large doses, even it turns out to be a strong poison, not to mention the toxic additives present in alcohol surrogates and capable of causing severe poisoning even in minimal doses.

Complications and consequences

Ingestion of alcohols and prolonged inhalation of concentrated vapors often causes serious alcohol poisoning, which does not pass without a trace. Given the impact of these toxic substances on the CNS, various organs and body systems, it is not surprising that at high doses or prolonged exposure to them, changes in the organs may be irreversible. And it is not only about the degradation of the alcoholic's personality, which at a certain stage can no longer be stopped.

Alcohols have a great effect on the organs of vision, and it is not surprising that regardless of the type of alcohol, one of the symptoms of poisoning is all sorts of visual disturbances: reduced visual acuity, blurred vision, nystagmus, double vision. Blindness is a fairly common consequence of severe poisoning, especially in the case of technical alcohols and alcohol surrogates. Irreversible damage to the optic nerve is also possible.

It is impossible not to mention the negative impact of alcohol and alcohols with their irritating effect on the GI tract. Even in small doses, alcohol irritates the mucosa, provoking inflammatory and ulcerative processes in the digestive organs: acute gastritis, acute pancreatitis (alcoholics' disease), development of gastric and duodenal ulcers.

Toxic effects on the liver lead to the development of hepatitis (inflammation of the liver) and liver failure. All types of alcohol affect the kidneys (the body's main filter) to a greater or lesser extent, provoking the development of kidney failure.

Under the influence of alcohols are possible:

• inflammatory processes in the heart muscle (myocarditis) and persistent heart rhythm disorders that increase the risk of myocardial infarction,
• paresis and paralysis of the legs and arms,
• Speech disorders (may become persistent, caused by hypoxic damage to the CNS and speech areas of the brain),
• psychosis (alcoholic delirium),

One of the usual complications of alcohol poisoning and alcoholism is encephalopathy, i.e. Acquired organic brain damage, accompanied by dystrophic changes in brain tissue and impairment of its functions. A person's memory deteriorates, there is noise in the head, disorders of consciousness, dizziness, a tendency to suicidal thoughts, apathy, depression, narrowing the circle of interests. It becomes difficult for patients to express their thoughts, they speak a lot but unspecific, the level of criticality of thoughts decreases, etc. The disease is long-lasting, and treatment consists of several courses over a year plus a recovery period.

The most severe consequences of alcohol poisoning can be considered a deep coma and death of the patient. The cause of not infrequent deaths in severe poisoning is acute respiratory failure, and only professional medical assistance helps to save a person's life, but not health. [7]

Diagnostics of the alcohol poisoning

Alcohols, despite their organic nature, for the human body are considered a poison, so alcohol poisoning can not be equated with banal food poisoning. In the food industry and medicine, it is customary to use only ethyl alcohol, which in low doses does not show toxic effects. But even this alcohol in large doses is toxic, not to mention technical liquids that are not intended for ingestion or inhalation because of their poisoning effect.

Despite the general typicality of the clinical picture of intoxication, the general picture of poisoning with the use of different alcohols will be somewhat different. In addition, there are certain patterns that help to make a fairly accurate diagnosis already at the initial examination of the patient. For example, a strong specific odor of alcohol from the patient indicates that he used ethyl alcohol. In technical alcohols, the aroma is not so strongly expressed, and the smell of ammonia (when using ammonia) is difficult to confuse with something else. In addition, in alcohol poisoning, inappropriate behavioral reactions are conspicuous.

But given the seriousness of the situation and the possibility of a lethal outcome, doctors in the diagnosis of alcohol poisoning can not rely only on the existing subjective opinion. Much attention is paid to the study of the history of poisoning: the nature and amount of liquid consumed, the date of the last intake, a single intake or a binge, alcoholic experience, etc. At the same time, the social status of the victim may give some clues.

The question of time is particularly acute due to the fact that it is not always possible to understand at once what exactly caused the poisoning. If the patient consumed a surrogate of alcohol, where there was ethanol, methanol and other impurities, ethanol in this rattlesnake mixture will be the least of the troubles. Symptoms of ethanol poisoning are evident in the first 24 hours. However, somatic symptoms indicating methyl alcohol poisoning (confirmation that the patient was poisoned by a surrogate), appear later, 2-3 days later. And on the 3rd day, the severity of toxic symptoms is not so great, because part of the poisonous substances during this time is already excreted from the body, and the distinct odor of alcohol will not be at late treatment. [8]

In the case of acute poisoning, doctors have to make diagnoses in camping conditions at the pre-hospital care stage. Most often, the ambulance is called by other people, from whom most of the information can be obtained. The rest of the information is obtained from the patient, if he is conscious. In parallel, the doctor needs to assess the severity of the patient's condition and the risk of lethal outcome, to determine the presence of neurological and behavioral disorders. If the fact of chronic alcoholism is confirmed, it is important to determine the risk of withdrawal syndrome, the state of the patient's liver and kidneys, the presence of diseases and the functionality of vital organs, but this will require a more complete examination of the patient.

It must be said that it is not always easy to get reliable information from the patient. Many people try to hide the fact of drinking alcohol and its substitutes. If possible, it is better to conduct a rapid analysis of the contents of the bottle. When dipping a red-hot copper wire into alcohol with an admixture of methanol, you can feel the specific odor of formaldehyde.

The use of a breathalyzer makes it possible to establish the fact of drinking alcohol, but does not identify the alcohol that caused the poisoning. The study of anamnesis and clinical picture allows doctors to determine the direction of first aid, and physical examination allows to clarify the severity of the condition. But the decisive value is still a laboratory diagnosis, allowing to determine the presence and differentiate poisons in the body of the victim. In this case, both blood tests and urine tests will be indicative. The latter will also provide valuable information about the state of the patient's kidneys, while the reaction of the liver can be determined by the level of bilirubin in the blood. [9]

To clarify the etiopathologic factor of poisoning:

• assess acid-base status, electrolytes and osmolar pressure of blood plasma,
• conduct a blood gas study (gas and gas-liquid chromatography, which allows the identification of alcohols, is considered one of the most effective express-methods),
• calculate the content of formic acid (in case of poisoning with methanol or formyl alcohol).

Examination of blood sugar levels allows acute alcohol poisoning to be identified with painful accuracy by persistent hypoglycemia.

To determine the toxic effects of alcohol, screening testing is performed, which involves a series of repeated tests: AOC, biochemistry, and blood toxicology.

If methyl alcohol poisoning is suspected, specific instrumental diagnostics is performed, which allows not so much to confirm the fact of poisoning, but to determine the strength and nature of organ damage. Since methanol has a strong negative effect on the organ of vision, it is this organ that is given special attention. Ophthalmoscopy on the 2nd or 3rd day after methanol consumption will show retinal edema, dilated veins, the presence of hemorrhages, swelling, redness and signs of optic nerve atrophy. These symptoms will worsen over time.

Optical coherence tomography and fluorescence angiography show nerve fiber edema and fluid accumulation in the retina, widespread reduction in retinal thickness, characteristic of methanol poisoning.

Computed tomography of the head will also indicate optic nerve damage and the presence of necrotic foci in brain tissue that occur after 2-3 days.

Neurological and behavioral symptoms associated with alcohol use require closer examination, as these same symptoms may be part of the clinical picture of some CNS diseases of other etiologies. This is especially important if the patient is unconscious. Here it is important to differentiate mild signs of CNS depression from severe brain damage caused by disease, trauma, or medication. [10]

Differential diagnosis

Differential diagnosis should answer not only the question about the etiopathologic factor of alcohol poisoning and its severity, but also what the doctor is dealing with: alcohol coma or a condition caused by other negative factors (trauma, poisoning with surrogates, drugs, low sugar levels - hypoglycemic coma in diabetes).

In case of death of the patient, forensic medical diagnosis of alcohol poisoning is carried out. The fact is that technical alcohol can be a tool for deliberately causing harm to the health and life of the patient. The manufacture of surrogates, as a result of which cases of mass alcohol poisoning are known (such situations are subject to mandatory investigation), is also a justiciable case.

Forensic diagnosis provides comprehensive information on the effect of different alcohols on the human body, the dependence of symptoms on the dose and time of exposure to alcohol, antidotes, etc. It also makes it possible to assess the relevance of the diagnosis and the relevance of the therapy.

Treatment of the alcohol poisoning

Poisoning with different alcohols can have slightly different consequences, but all of them are undesirable for the body. If for alcohol poisoning with ethanol, the most dangerous condition is considered to be loss of consciousness and coma when the dose is exceeded (most often this is the result of a constant practice of alcohol abuse), then poisoning with methanol and formic acid carry not only CNS depression, but also serious irreversible damage to internal organs, even with a single use. In any case, it is impossible to leave a person without medical help in such a state. But often the person himself cannot or does not want to go to the doctors.

A person who is near the victim and does not have medical knowledge, can not independently make an accurate diagnosis and provide qualified assistance. But only time does not play into the hands of the patient, so you need to do everything to get into the body of alcohol caused as little harm as possible. And this is possible if it is possible to reduce its concentration and toxicity.

Gastric lavage is one of the most important steps in pre-hospital care for poisoning from peroral poisoning. If the type of alcohol taken is unknown, it is better to do gastric lavage with clean warm water, letting the patient drink about 1 liter of liquid and, if necessary, inducing vomiting by pressing on the root of the tongue.

Since most often people are poisoned by surrogate alcohol, namely methylene, contained in it often in lethal quantities, many people are interested in what to wash the stomach with methyl alcohol poisoning? For this purpose are suitable clean warm water, salt or soda solution. It should be said that sodium bicarbonate, aka baking soda, is used even in hospitals in case of severe acidosis (acidification of the body), characteristic of methanol poisoning.

In poisoning with ammonia alcohol, lavage is done with acidified water, but in the absence of severe vomiting and cutting pain in the stomach and esophagus, indicating damage to the mucosa. If a person is unable to swallow the liquid, 2 spoons of citric acid are dissolved in boiling water and give the patient to breathe the vapors.

In case of ethylene glycol poisoning, 2% soda solution is used for gastric lavage, and in rare IPS poisoning, gastric lavage with water and plenty of water is sufficient.

It is important to take into account that a significant part of alcohol is absorbed into the blood already in the lumen of the stomach, so a single lavage in poisoning a person can not save from severe consequences. Referral to a medical institution (by ambulance or independently) is mandatory, especially if the patient drank industrial alcohol or inhaled toxic vapors.

Some of the toxic substances can reach the intestine, from where it is actively delivered to the blood. Cleansing of the intestines at home is carried out with the help of a salt laxative, but before this it is desirable to give the patient to drink activated charcoal at a rate of 1 tablet per 10 kg of weight of the victim.

Given the rate of absorption of alcohols, these procedures will be effective only in the first minutes after ingestion of alcohol-containing liquids. It makes sense to give activated charcoal within half an hour after drinking alcohol.

Reduce the toxic effects of poisonous substances can help substances that accelerate their metabolism and reduce the risk of toxic metabolites. Knowing the antidote for alcohol poisoning can save a person's life and health.

Ethanol has no specific antidote. Brine helps to reduce the severity of hangover symptoms by normalizing the water-salt balance, but does not reduce the toxicity of ethanol. Only fatty and enveloping foods can affect the absorption of ethanol into the bloodstream.

IPA is well absorbed by activated charcoal (1 g of activated charcoal absorbs 1 g of alcohol), so the absence of an antidote is not significant here.

A well-known and very effective antidote for methyl alcohol poisoning is ethanol of 30% concentration (you can take quality vodka). The first dose should be at least 100-150 ml, after 3 hours the reception is repeated, but the dose is halved. In the future, the patient will have to give ethanol for another 3-5 days several times a day (the daily dose is calculated from the ratio of 1-2 g of ethyl alcohol for each kg of the patient's weight).

In the same way act in poisoning with ethylene glycol or formyl alcohol. By the way, accelerate the elimination of formic acid from the body helps and folic acid, which the patient should be given 5-6 times a day 50-100 mg.

In case of poisoning by alcohol vapors, gastric lavage is pointless, as well as taking absorbents. In this situation, it is necessary to remove the person from the room with contaminated air, provide him with free breathing, freeing him from the squeezing clothing of the neck and chest area. Then it remains only to wait for the arrival of medical personnel or transport the patient to a medical facility on his own.

If the victim is unconscious, no forced lavage or administration of activated charcoal should be performed. The person is placed on a flat surface on his or her side to prevent vomit from entering the respiratory tract.

Do not perform cleansing procedures before the arrival of the ambulance and if the patient has bloody vomiting or blood streaks in the vomit, which indicates damage to the stomach and/or esophagus.

Artificial provocation of vomiting causes a lot of controversy, because not always such a procedure will benefit. If a person is in a state of strong or heavy intoxication and has poor control over his reactions, he can simply choke on vomit. Therefore, with this measure of assistance should be especially careful and attentive, especially since its effectiveness raises doubts among many doctors.

In case of cessation of breathing and absence of heartbeat, it is necessary to carry out resuscitative measures: artificial respiration, indirect cardiac massage. Ideally, you should try to keep the person conscious as long as possible, not allowing him to fall asleep or pass out.

In any case, in severe alcohol poisoning, the patient should be taken to the hospital, being sure to inform the doctors of the ambulance or at the emergency room about the pre-hospital care manipulations. [11]

What not to do in alcohol poisoning:

• Put a person to sleep or leave him or her alone without supervision if there are symptoms of alcohol poisoning. A drunk person can sleep it off, but with poisoning the blood alcohol level can rise (in ethanol intoxication this happens within hours and in methanol - several days) and sleep will not change this. Do not be indifferent, referring to the fact that no one forced the person to get drunk. Situations vary, and the victim is often simply unable to explain what happened to them. Vomiting, convulsions, livid color of the skin and confused consciousness should alert everyone even in the absence of complaints. Without help, a person can lose consciousness and fall into a coma, from which not everyone comes out, even with professional help.
• Alcohol is one of the factors that actively reduces the fluid content in the body and disrupts homeostasis. The opinion that coffee as an antioxidant removes toxins and free radicals, so it should be consumed as an antidote to alcohol, is erroneous. This drink is not an antidote, not only that, it also contributes to the loss of body fluids. If you treat alcohol poisoning with coffee, there is a risk of dehydration.
• Ethanol tends to raise body temperature slightly at first and then lower it as the level of its concentration in the blood rises. Exposing the victim to cold air or a "sobering" cold shower can cause hypothermia very quickly.
• Ethanol is an antidote for other alcohols, but it should never be taken further if symptoms of ethanol poisoning occur. Further increase in the level of ethanol in the blood will be destructive to all systems of the body. And when poisoning with methanol, ethylene glycol, formyl alcohol should not overdo it. 30% ethanol should be drunk in small doses with an interval of 3-4 hours, not the more, the better.
• In case of alcohol poisoning, you should not resort to folk methods of treatment to the detriment of professional medical care. Any intoxication does not pass without a trace, and its consequences can remind of themselves in a few days and months. It is better to reinsure yourself by calling an ambulance than to heal yourself or another person to death. Statistics show that very often such patients are admitted to the hospital when doctors can no longer give any guarantees.

Treatment of alcohol poisoning

First aid in alcohol poisoning helps to buy time, but the manipulations carried out are not enough. In addition, if a person is unconscious, it becomes impossible to carry out effective procedures.

In the hospital, the victim is first of all prescribed detoxification therapy:

• Probe gastric lavage (if necessary). Its effectiveness in ethanol intoxication is questionable, since this alcohol quickly penetrates into the blood, actively absorbed already in the upper GI tract. But the elimination of methanol through the mucosa is much slower, so it makes sense to carry out even a series of lavages.
• Administration of absorbents if little time has elapsed after alcohol ingestion (for IPS this interval is 30 minutes, for methanol more). For ethanol, the effectiveness of activated charcoal is questionable.
• Hemodialysis (one of the most effective procedures to cleanse the blood of toxic substances). The procedure is started before the patient is admitted to the hospital.
• Fasted diuresis in the absence of serious impairment of renal function.
• Antidote administration. If the person is unconscious or has difficulty swallowing, the antidote is administered intravenously or through a tube. In methanol poisoning, a 5-10% solution of ethanol diluted in glucose solution or "Fomepizole", "Methylpyrazole" (alcohol dehydrogenase inhibitors) is administered intravenously. This is done in the conditions of the hospital. To neutralize the products of cleavage of ethylene glycol, calcium gluconate is also prescribed.

To relieve pain symptoms, patients are prescribed glucose with novocaine and prednisolone, and vitamins B and C for early recovery. In case of indomitable vomiting, measures are taken to prevent dehydration (rehydration is administered intravenously in case of severe vomiting).

In addition, infusion of crystalloid (saline) solutions to restore the volume of fluid in the body. In case of severe acidosis in severe poisoning, patients are administered sodium bicarbonate.

Indications for transfer of the patient to the intensive care unit are coma, a sharp drop in BP, respiratory failure. Indications for surgical treatment are acute renal failure. In such cases, the patient requires transplantation of the organ.

Physiotherapeutic treatment in connection with poisoning is not often carried out. The most popular physiotherapeutic method is oxygen therapy, the need for which is due to oxygen deficiency of body tissues (and in particular the brain) caused by the depressing effect of alcohol on the CNS.

Physiotherapy may also be needed in the recovery period to accelerate the regeneration of damaged tissues and improve the performance of affected organs. Since any poisoning is a blow to the excretory system, and in particular to the kidneys, such physiotherapeutic procedures may be prescribed if the functionality of the organ is impaired:

• electrophoresis with magnesium, calcium chloride, and, if necessary, antimicrobials,
• pulsed ultrasonic baths,
• exposure to centimeter waves,
• thermal procedures, namely exposure to high-frequency currents, mud wraps, paraffin therapy, etc.

In any case, the doctor's appointments are individualized, taking into account the type of alcohol, the severity of poisoning and the presence of damage to vital organs.

Medications

The first aid rendered in intoxication and subsequent therapeutic manipulations are aimed at saving the life of a person and, if possible, restoring the disturbed functions of the body. At the stage of pre-hospital care in the forefront are detoxification procedures that allow to reduce the toxicity of alcohols and thereby minimize the damage done to the body. One only gastric lavage and optimization of the drinking regimen is not the case. Much more effective in this regard the action of absorbents. And in the case of alcohol poisoning (and most often we are talking about poisoning by low-quality alcohol) can be used any absorbents that are at hand.

It is worth saying at once that it is pointless to protect yourself from a hangover or poisoning by taking sorbents on the eve of taking alcohol. A person will still not stop until he feels the desired intoxication, but the absorbent by that time will already be full of toxins and will not absorb their new doses, and even on the contrary, will give in the intestines already accumulated.

But after taking an excessive dose of alcohol or absorption of surrogates sorbents will help reduce intoxication. The fact is that the toxins that have entered the blood and successfully passed through the liver filter are absorbed back into the GI tract. Such a cycle of toxins in the body causes pathological processes in various organs, and sorbents are designed to stop it.

Now, as for the choice of sorbent. Activated charcoal is considered a good remedy for hangovers and alcohol poisoning, but a pronounced detoxification effect can be obtained by taking a dose of not 1 tablet per 10 kg of the patient's weight, but about 30 g of active ingredient, which is neither much nor little 60 tablets.

"Sorbex" - a drug based on activated charcoal, but with a larger active surface (sorption capacity) is more suitable for the treatment of alcohol poisoning. But even in this case, the minimum dose will be 6 capsules of the drug, ie from 2 capsules three times a day. Ideally, a single dose for an adult will look like 6 capsules 3 times a day. For children over 6 years of age, 1-3 capsules 3-4 times a day is enough.

Activated charcoal preparations are not prescribed in case of hypersensitivity to their components, exacerbation of gastric and duodenal ulcers, erosive lesions of the GI tract in the active stage, bleeding from the GI tract. Sorbents are not prescribed for violations of intestinal permeability, constipation. Children under 6 years of age are given activated charcoal in dissolved form (tablets are crushed, capsules are opened and the powder is released from the gelatin shell).

In general, activated charcoal is considered a safe drug. Side effects from its use are rarely noted and are reduced to nausea and vomiting in case of intolerance to the substance, as well as stool coloring in black. With prolonged use, stool disorders and absorption of useful substances in the intestine may occur, which requires correction.

When taking sorbents other drugs it is very important to observe the time interval - 1-1.5 h to avoid reducing the effectiveness of the latter.

Even more pleasantly doctors refer to the drug "Enterosgel" based on silicon, which has a wide spectrum of action and a large sorption area. This is an absorbent with a detoxifying effect, preventing both exogenous and endogenous toxicosis, without impairing the absorption of useful substances and vitamins, without affecting intestinal motility.

The drug is available in the form of a paste, which is recommended to take outside of meals and medications, adhering to an interval of 1-2 hours.

Take the drug three times a day for 1-1.5 tbsp., mixing it in water in a ratio of 1:3. The daily dose for an adult is 45-67 g. Children 1-5 years old are given ½ tbsp. Of the drug, mixing it in water or milk. The single dose for infants is ½ tsp. And the frequency of use 6 times a day.

In acute intoxication sorbent is given for 3-5 days or more. If the poisoning is severe (which is most often the case), the dose should be increased by 2 times.

"Entorosgel" is not prescribed for individual intolerance, as well as in cases where there is no regular stool: intestinal atony, intestinal obstruction of various etiologies, chronic constipation.

Among the side effects of the drug are constipation and nausea. Sometimes there is a feeling of aversion to the drug against the background of renal or hepatic insufficiency.

As an effective absorbent and antioxidant, as well as a source of useful amino acids, preparations of succinic acid are prescribed. "Succinic acid" can be purchased in tablets and capsules.

The drug not only helps to eliminate toxins from the body, but also improves cerebral blood circulation, which is important in conditions of toxic hypoxia, heart function, relieves pain, improves the performance of the body as a whole. Acid helps to accelerate the excretion of alcohol and reduce its toxic effect on the body.

The drug is taken before meals at 250 mg 3-4 times a day for up to 10 days (the doctor may adjust the dose). If you take the drug in the same dose before drinking alcoholic beverages, the probability of severe poisoning will be significantly reduced.

The drug is contraindicated in case of individual sensitivity to its composition, hypertension, cardiac ischemia, gastric and duodenal ulcer, glaucoma. It is not prescribed for children and pregnant women, especially in the 2-3 trimester.

The side effects of succinic acid include the ability to increase blood pressure, as well as cause stomach pain by increasing the secretion of gastric juice. However, most often the drug is not accompanied by unpleasant sensations.

Specific drugs that are not sorbents, but can reduce the toxic effects of alcohol on the body include "Glycine" - a drug based on aminoacetic acid, which belongs to the category of amino acids. This is a known regulator of metabolism in the nervous system and metabolism in the body as a whole. In the treatment of alcohol poisoning are particularly valuable are its antitoxic and antioxidant effects. In addition, it reduces the severity of autonomic and neurological symptoms in alcoholic lesions of the nervous system and is used as an adjuvant in the treatment of alcoholism.

The drug is available in tablets, which are allowed to be crushed into powder. It should be taken by swallowing the tablets, placing them under the tongue or between the upper lip and the gum (sublingually or transbuccally).

According to the official instructions, the drug is taken 1 tablet up to 3 times a day for 2-4 weeks. But in case of severe poisoning, the scheme may be changed by the attending physician.

The drug is not prescribed in case of hypersensitivity to it, as well as in severe arterial hypotension. In people with a tendency to BP spikes, the drug is administered with caution, regularly monitoring blood pressure readings. If the pressure drops below the normal level, the drug should be discontinued.

As for side effects, they are categorized as possible, but rarely occur. Sometimes there are complaints of nausea, abdominal pain, bloating, etc., rarely it is about headaches, impaired attention, irritability, anxiety. Allergic reactions may also appear in the form of runny nose, skin rashes, sore throat, itchy skin, inflammation of the conjunctiva.

The property of ethanol to affect the water-salt balance in the body causes irreparable damage to the latter. In hospital conditions (with impaired consciousness, incessant vomiting, severe condition of the patient) with dehydration is fought by drip infusion of saline (0.9% sodium chloride solution), after which special compositions with electrolytes are prescribed. To mitigate the consequences of such an effect of alcohol at home help drugs-regidratants, the most famous of which is "Rehydron".

The drug is available in sachets, the contents of which are dissolved in cooled boiled water (1 sachet per 1 liter of water). It is not recommended to use other liquids, because "Rehydron" has a balanced composition of electrolytes, thanks to which it has a specific effect.

The drug is taken orally. If a person is unable to swallow liquids, the medicine can be administered through a probe under the supervision of a doctor.

The dosage of the drug is determined based on the patient's body weight and fluid loss. The latter is determined by weighing. With a decrease in body weight by 0.5 kg, 1 liter of solution should be taken, 0.4 kg - 800 ml, etc. Such a dose of the drug is given for 6-10 hours, after which the drug begins to be used according to the scheme attached to the instructions.

The course of treatment usually does not exceed 4 days in the presence of such symptoms as vomiting and diarrhea. After stabilization of the patient's condition and disappearance of these symptoms, the drug is discontinued.

Since alcohol has an irritating effect on the mucosa of the GI tract, patients are often prescribed drugs that promote healing of tissue microdamage. These are antacids ("Rennie"), enveloping solutions ("Almagel", "Fosfalyugel"), antagonists of gastric secretion ("Omez", "Omeprazole"). Such agents should be used separately from other drugs, observing a time interval of 1.5-2 hours.

In addition, patients are shown a special diet, excluding the intake of fatty, spicy, fried food, alcohol, carbonated drinks. It is desirable to grind food and take small portions, providing the GI tract gentle mode. But you should drink plenty of fluids.

Folk treatment

Treatment of alcohol poisoning at home is possible only in mild intoxication, which is not accompanied by pronounced neurological disorders. For example, with the abuse of high-quality alcohol or the use of a small dose of IPA. In poisoning with technical alcohol (including IPS in high dosage) is not worth the risk, because the same methanol may not immediately give symptoms of serious concern, and subsequently provoke a number of neurological disorders. In poisoning in a child, home recipes can be used only as auxiliary means after stabilization of the condition of the small patient.

Folk medicine knows some products and procedures that help accelerate the elimination of toxins from the body, including products of alcohol metabolism:

• Citrus juices and citrus cocktails. Juices of orange, grapefruit, lemon and other citrus fruits are rich in vitamin C, which is a well-known antioxidant, organic acids, pectins that help detoxify the body. You can consume freshly squeezed juices with the skin and cocktails with the addition of honey, mineral water, ice. But with developing acidosis with such treatment should be delayed, taking into account the acidity of drinks.
• To reduce discomfort in the stomach used decoction of oats. This is a tonic and enveloping agent, beneficial effect on the microflora of the stomach and intestines, relieves symptoms of hangover (1 tbsp. Oats to 1.5 liters of water).
• In alcohol poisoning to get rid of unpleasant symptoms apply fresh chicken protein (dose - whites of 3 eggs).
• Nashotir alcohol. It is actively used in ethanol poisoning (10 drops in ½ tbsp. Water at intervals of 20 minutes several times a day until the symptoms disappear). But it is important to observe the dosage, so as not to aggravate the situation with ammonia poisoning. At home, it is safer to treat with chicken whites (but there is a risk of catching salmonellosis, if there is no confidence in the quality of eggs) or apple cider vinegar (1 tsp. Per ½ tbsp. Water).

As for procedures, folk healers agree that the most useful in alcohol poisoning will be sauna (not a sauna!!!) due to the activation of metabolic processes and blood circulation. In general, the sauna has a pronounced detoxification effect, contributing to the active excretion of poisons from the body, while not creating a large load on the cardiovascular system. It is recommended three times the procedure with a gradual increase in duration from 5 to 20 minutes, which should be carried out under the supervision of close people who can help if the condition worsens.

Practiced in folk medicine and treatment with herbs that have the property to stimulate the excretion of toxins and alleviate the symptoms of intoxication:

• Infusion of melissa herb (used for nausea and vomiting): 4 tbsp. Dry raw materials for 2 tbsp. Boiling water, insist in warmth for 4 hours, take half a cup before meals.
• Decoction of blackberry shoots (helps with vomiting): 1 tbsp. Crushed raw material to 1 tbsp. Water, boil for 5 minutes, insist for about an hour, drink in small portions for 50-60 minutes. A similar effect has a similar effect and celery root.
• Elecampane root is used as a detoxicant: 1 tbsp. Crushed raw material on 1/2 tbsp. Boiling water, insist 20 minutes, take 1 tbsp. 4 times a day.
• Well-proven in the elimination of toxins and choleretic decoctions (pyzhma, St. John's wort).
• With alcohol and other types of poisoning will help relieve the condition of such a collection: chamomile, mint, St. John's wort, plantain, drugstore turnip (1 tsp. Dry raw materials for 0.5 liters of boiling water, insist about 30 minutes, take during the day 1/3 cup at intervals of 1 hour).
• Dill is a great helper in alcohol intoxication, because it helps to eliminate products of ethanol metabolism, has diuretic properties, has a calming effect, has a beneficial effect on the heart and blood vessels, helps to reduce vomiting. The plant can be used in different ways:

• in the form of tea (1 tbsp. Seeds or herbs to 1 tbsp. Boiling water, insist 5 minutes),
• in the form of decoction (same dosage, boil for 15 minutes),
• in the form of dill water (40 g seeds to 0.5 liters of boiling water, insist 60 minutes in a thermos).

Turning to the help of folk recipes, it should be remembered that most of the fatalities are due to the fact that patients did not seek help in time in medical institutions, and tried to treat with folk methods. Such treatment is relevant as an auxiliary measure, symptomatic treatment, but the main therapy should be prescribed by specialists, taking into account the patient's condition and etiopathogenic factor (type of alcohol).

Homeopathy

Despite the negative attitude to homeopathy on the part of many doctors of traditional medicine, it has a rich experience in the treatment of alcoholism and alcohol poisoning, including its surrogates. In this case, not a standard scheme of treatment is used, equalizing all patients, but an individual approach, which takes into account not so much alcoholic experience and severity of poisoning, as the peculiarities of the body and psyche of the patient. Still, there are homeopathic remedies that are relevant in alcohol poisoning, regardless of the individual who uses it.

Thus, NUX VOMICA is considered a potent antidote for alcohol poisoning (as well as for drug or drug poisoning), so it is prescribed in most cases of acute and chronic intoxication. The drug is used in potency 6x:

• 3 doses per day with an interval of 30 minutes in acute poisoning,
• 2-3 times a day for six months to cleanse the body of toxins.

If in case of alcohol poisoning the patient has pale and blue code, chills, cold sweat, cold fingers and toes, which indicates weakness of blood circulation, CARBO VEGETABLIS 200 is prescribed. The drug is taken alone or in combination with NUX VOMICA (dilution of both drugs 30, 3 times a day for chronic intoxication).

In case of methyl alcohol poisoning, the drug PLUMBUM is relevant. Symptoms: memory loss, slowed speech, reduced reaction to pain, paralysis and atrophy of muscles, constipation, feeling of bladder overflow. The drug is administered in dilution 30 three times a day for 7 days.

Homeopathic preparations from the category of silicon-based sorbents can also be purchased in a regular pharmacy. The drug SILICEA is available in the form of granules (in different dilutions) and gel.

Granules should be chewed in the mouth (5 granules at a time). It is recommended to take them either half an hour before a meal or an hour after it. For children, the medicine is crushed and diluted in 10-15 ml of boiled water at room temperature.

The drug is not prescribed in case of individual sensitivity and lactose intolerance.

Gastrogel is available in dosed sachets, which should be thoroughly kneaded before use. It is taken 1-2 sachets (or 15 ml when measured with a measuring spoon) 3 to 5 times a day between meals.

The drug is not prescribed in case of hypersensitivity to silicic acid.

Sorbents should be properly combined with the use of other oral medications, observing a two-hour interval. It is very important to follow a drinking regime, eat a balanced, vitamin-rich diet.

Despite the apparent safety of homeopathic preparations containing microscopic fractions of active substances, it is advisable to use them after consultation with a doctor. In case of poisoning with technical alcohols, it is unwise to rely only on the help of homeopathy and folk recipes in the extreme stage. In case of severe poisoning without professional help of traditional medicine specialists there is a high risk of lethal outcome.

Forecast

Alcohol poisoning is quite common, especially among men, who have a special fondness not only for store alcohol and goods of their own alcoholic production, but also for all liquids containing alcohol, which they have to face in the household. But the prognosis for the patient's life and health depends not on gender, but on the severity of poisoning and the timeliness of care.

As for the severity of intoxication, liquids with a high methyl alcohol content, and in particular alcohol surrogates, come to the fore. Severe poisoning with isopropyl alcohol is rare because of the ability of this substance to quickly cause severe intoxication. Severe ethanol poisoning is only possible with chronic use of high doses or a single dose that is significantly higher than normal.

When poisoning with methyl alcohol, first of all, the organs of vision are affected, and often these changes are irreversible. A person can simply lose vision due to the toxic effects of ethanol. Slow development of the clinical picture becomes the reason for late application for help, and in this case the prognosis is usually unfavorable. But on the other hand, without medical help, the patient may die even in case of severe ethanol poisoning.

From this we can conclude that early application for help at the first signs of intoxication will help to improve the prognosis of life and health of patients. And the prognosis of cure depends on the severity of poisoning and the correct choice of treatment regimen, which implies adequate differential diagnosis.

Another way to make the prognosis of life favorable is to avoid the use of low-quality alcohol (ideally any alcohol other than medicines) and technical types of alcohol, and to minimize the use of certified spirits. This method refers to preventive measures against alcohol poisoning. Other measures are considered to be:

• proper storage of alcohol-containing liquids at home out of the reach of children,
• compliance with sanitary norms of air pollution in production facilities where alcohol-containing technical liquids are used, use of respiratory and skin protection equipment,
• proper use of household liquids containing alcohol (do not use in unventilated rooms, try not to inhale alcohol vapors or use respiratory protection),
• do not consume liquids with unknown composition (the smell of alcohol is not an indicator), carefully read the instructions for use,
• Educating adolescents and young people about the dangers of poisoning when drinking alcohol surrogates and technical liquids, as well as about the harm of alcoholic beverages to the body,

If a person cannot completely refuse to drink alcohol, alcohol poisoning can be prevented by purchasing alcoholic beverages from trusted outlets, checking the presence and integrity of the license stamp. At the same time, you still need to observe the measure and do not get carried away with daily alcoholic infusions. Life is the greatest value and it is foolish to lose it in this way.