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Source: Doering PL, Li RM. Substance-Related
Disorders: Alcohol, Nicotine, and Caffeine. In: DiPiro JT, Talbert
RL, Yee GC, Matzke GR, Wells BG, Posey LM, eds. Pharmacotherapy:
A Pathophysiologic Approach. 8th ed. http://accesspharmacy.com/content.aspx?aid=7987625.
Accessed June 11, 2012.
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- Acute detoxification and withdrawal after chronic alcohol
abuse a serious condition that can require hospitalization and adjunctive
pharmacotherapy. Death may ensue if blood alcohol concentration
(BAC) high enough.
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- Alcohol absorption begins in stomach within 5–10
minutes of ingestion.
- Peak concentrations usually achieved 30–90 minutes
after finishing last drink.
- Alcohol metabolized by alcohol dehydrogenase to acetaldehyde,
which is further metabolized to carbon dioxide and water by aldehyde
dehydrogenase.
- There is 14 g of alcohol in 12 oz of beer, 4 oz of wine, or
1.5 oz (one shot) of 80-proof whiskey. This amount increases BAC
by 20–25 mg/dL (4.3–5.4 mmol/L)
in healthy 70-kg man. Deaths from alcohol intoxication generally
occur when BACs >500 mg/dL (87–109 mmol/L).
- Alcohol withdrawal includes 2 main components:
- History of cessation or reduction in heavy and prolonged alcohol
use
- Presence of two or more of symptoms of alcohol withdrawal.
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- Slightly more than half of Americans (approximately 129
million people) aged 12 or older reported being current drinkers
of alcohol in a 2008 survey.
- 23.3% (58.1
million) participated in binge drinking.
- 6.9% reported heavy drinking.
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- Signs and symptoms of alcohol intoxication:
- Slurred
speech
- Ataxia
- Incoordination
- Sedation
- Nystagmus
- Impaired judgment
- Unconsciousness
- Nausea
- Vomiting
- Respiratory depression
- Coma
- Signs and symptoms of alcohol withdrawal:
- Tachycardia
- Diaphoresis
- Hyperthermia
- Hallucinations
- Delirium
- Seizures
- Table 1 relates effects of alcohol
to BAC.
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