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As well as methyl alcohol or methanol and ethylene glycol)

In poisoning with these substances a pathogenetic link is a narcotic effect on CNS leading to the development of clinical picture of intoxication up to a comatose state that is accompanied by disorders of respiration, cardiovascular activity and threat of fatal outcome. Substitutes, besides, cause a disorder of vision (methanol) and renal function (ethylene glycol).

In the majority of victims a recovery from an alcoholic coma is accompanied by a psychomotor excitation. More rarely (as a rule, in persons abused alcohol earlier) a recovery from coma occurs without excitation, but adynamia, sleepiness, neuropsychic asthenization are noted. In the postcomatose period, particularly in those suffering from a chronic form of alcoholism, a hangover syndrome is observed that may turn into alcoholic delirium in insufficient treatment. The latter differs from a classic delirium tremens arising in abstinence by its comparative short duration and is easily eliminated.

Sometimes, in ethyl alcohol intoxication a sharp deterioration of vision arises that may reach, for a few minutes, a complete blindness (alcoholic amaurosis). As distinct from methanol poisoning, blindness passes completely independently in several hours. Quite often, in postcomatose period severe bronchites and pneumonias arise due to an aspiration of mucus and vomits in the period of coma.

A dreadful complication of alcoholic intoxication is a syndrome of positional compression. It develops as a result of compression of separate groups of muscles of the extremities and trunk in case of prolonged lying in inconvenient position in the period of coma. Upon a recovery from coma numbness and pain are felt in the indicated areas of the body, edema, restriction of movements, appearance of vesicles on the skin of the affected area as in burns are noted. In the first 1-2 days a dirty brown urine, because of the great content of hemoglobin in it and a decrease of diuresis are noted. If urgent measures to restore a diuresis are not undertaken as in hemolysis, ARF may develop.

Treatment of alcoholic intoxication is carried out with observation of general principles of treatment of poisonings (urgent detoxication, therapy according to syndromes). There are no special antidotes against ethyl alcohol.

A particular feature of treatment of this kind of intoxication in the period of coma is providing a patency of respiratory tract. If after a 3-hour treatment of coma its depth does not decrease, one should think of the presence of unrecognized pathology (craniocerebral injury, simultaneous with alcohol intake of other coma-deepening substances, for example, narcotics or other psychopharmacological agents, cerebral circulatory disorder, diabetic, uremic, hepatic coma and other diseases).

In development of sharply pronounced psychomotor excitation or delirium it is necessary to prevent a possibility of trauma (patient's fixation), to administer i/m diazepam 2-4 ml or dimedrol 2-4 ml repeating, in case of need, these injections every 2-4 hours up to normalization of patient's mental condition.

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