Alcohol Toxicity Follow-up

Updated: Nov 01, 2018
  • Author: Michael D Levine, MD; Chief Editor: Jeter (Jay) Pritchard Taylor, III, MD  more...
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Follow-up

Further Inpatient Care

Patients with significant ingestions of toxic alcohols require hospital admission in a closely monitored setting such as the intensive care unit. Patients who are alcoholics may be at risk of alcohol withdrawal if admitted to the hospital.

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Transfer

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  • Patients with ethanol intoxication can be observed until they are no longer clinically intoxicated and then discharged.

  • Patients with isopropanol ingestion may require observation in the hospital.

  • Patients with known or suspected methanol or ethylene glycol intoxication should be monitored closely, probably in an intensive care unit.

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Complications

Ethanol ingestion complications include the following:

  • Hypoglycemia is common. [26] The etiology is multifactorial but largely related to decreased glycogen stores and malnutrition in children and chronic alcoholics, as well as ethanol’s inhibition of glycogenolysis.

  • Patients with acute intoxication may exhibit "holiday heart," in which dysrhythmias, especially atrial fibrillation, occur following a heavy drinking episode. Ethanol lowers the threshold for developing atrial fibrillation.

  • Cirrhosis, esophageal varices, and erosive gastritis are common in patients who use ethanol on a frequent basis.

Complications of other alcohols include the following:

  • Ingestion of isopropanol is associated with hemorrhagic gastritis.

  • Ingestion of methanol is associated with blindness, acidosis, coma, cardiovascular collapse, and death.

  • Ingestion of ethylene glycol is associated with renal failure, acidosis, coma, cardiovascular collapse, and death. [22]

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