Definition

Acute intoxication occurs when an individual consumes or is exposed to a large amount of a specific substance, such as alcohol, narcotics, antidepressants, benzodiazepines, or other toxins, in a short period, resulting in poisoning. Acute intoxication is a serious condition as it can affect behavior, body temperature, respiration, heart rate, and consciousness, potentially leading to death if not promptly addressed.

Acute intoxication can affect anyone, whether young or adult. This condition is associated with the intake of large quantities of certain substances into the body. However, in some cases, individuals may experience acute intoxication accidentally due to the consumption of large amounts of alcohol-containing products such as rum or even mouthwash.

Acute intoxication is considered an emergency condition. If you observe that someone you know has ingested or inhaled substances that could lead to acute intoxication, seek medical help immediately. Acute intoxication is often linked to suicide attempts or self-mixing of alcoholic beverages.

Read more: Alcohol Intoxication - Definition, Causes and Risk factors.

Causes

Acute intoxication is one of the conditions that lead to a decrease in consciousness. As mentioned earlier, acute intoxication can occur if one ingests or inhales the following substances in excessive amounts and over a short period:

• Food or beverages containing alcohol.
• Narcotic substances that can relieve pain, induce drowsiness or sleep, create feelings of euphoria in some drugs, and lead to addiction.
• Antidepressants used for treating depression.
• Benzodiazepines, which slow brain activity and the nervous system.
• Organophosphates, synthetic chemicals typically found in pesticides.
• Volatile compounds that can be inhaled.

Risk factor

Risk factors for acute intoxication include:

• Male gender.
• History of narcotic and illicit drug use.
• Addiction to alcohol or illicit substances.
• Young adulthood.
• Body type and weight; individuals with larger bodies may metabolize alcohol more slowly.
• History of PTSD (Post-Traumatic Stress Disorder).

Symptoms

Common symptoms of intoxication include:

• Seizures
• Digestive disturbances
• Decreased consciousness
• Altered mental status

Symptoms can deteriorate rapidly. However, it is important to note that the symptoms of intoxication vary depending on the type of toxin or substance.

• Alcohol intoxication: Symptoms may include gastrointestinal issues such as vomiting, nausea, abdominal pain, decreased consciousness, and impaired vision.
• Methamphetamine intoxication: Symptoms may involve increased blood pressure, elevated temperature, persistent sweating, psychotic symptoms such as hallucinations, severe agitation, seizures, and coma.
• Organophosphate intoxication: Symptoms can include increased urination frequency, diarrhea, abdominal pain, vomiting, decreased heart rate, shortness of breath, and increased salivation and lacrimation.

Diagnosis

As acute intoxication is an emergency condition, diagnosis must be swift and precise to administer appropriate treatment based on the causative substance. Toxic substances have distinct characteristics, and the patient's clinical presentation can be assessed through physical examination and supporting tests.

Medical interview

Typically, patients with acute intoxication are brought in by acquaintances, as they usually arrive with reduced consciousness. The doctor will quickly ask the accompanying person several questions:

• Duration of the condition.
• Patient's condition at the time of discovery.
• Current and past medical history.
• History of medication, narcotic, or alcohol use.
• Pregnancy history in female patients.

Physical examination

The doctor will then assess vital signs such as consciousness, blood pressure, body temperature, respiratory rate, and pulse. The examination will cover the patient's condition from head to toe, evaluating aspects such as neurological, digestive, and respiratory systems. In the neurological examination, reflexes will be tested, typically showing reduced responses in intoxicated individuals.

Given that patients generally present with decreased consciousness, the doctor will quickly determine if the condition is due to metabolic disturbances, infection, nutritional deficiencies, structural organ issues, or intoxication.

Supporting tets

Supporting tests are crucial for identifying the cause of the patient's condition and confirming the diagnosis. Tests may include blood and urine analyses to identify the intoxicant, whether alcohol, narcotics, psychoactive substances, or organophosphates. For example, blood and urine alcohol levels can be measured.

In severe cases, additional laboratory tests may be conducted, such as:

• Electrolyte levels
• Liver function
• Kidney function
• Blood clotting times

Other supporting tests may be performed if physical examination reveals symptoms suggesting other diseases, such as:

• Electrocardiogram (EKG)
• Imaging studies like X-ray, ultrasound, or CT scan if necessary

Management

Management of intoxication must be prompt and precise to prevent the patient's condition from worsening, as multiple organ systems are often involved. Delayed treatment can lead to deterioration or death.

Management includes:

• Active monitoring of vital signs, oxygen saturation, and the patient's condition.
• Preventing choking and respiratory issues with respiratory support.
• Administering oxygen to maintain oxygen saturation around 97%.
• Measuring blood glucose levels and administering glucose IV fluids if hypoglycemia (low blood sugar) is detected.
• Establishing venous access for IV fluids and medications.
• The doctor will aim to eliminate toxins from the body and administer antidotes if available. For example, in opioid poisoning, naloxone may be administered. For alcohol intoxication, IV fluids may be given to prevent dehydration, and thiamine (Vitamin B1) to prevent Wernicke's encephalopathy. In organophosphate poisoning, atropine may be used.

If the patient stabilizes and further examination or specific treatment is required, they may be referred to a more comprehensive healthcare facility.

Complications

Various complications can arise from acute intoxication, including:

• Digestive disturbances
• Liver dysfunction
• Kidney impairment
• Decreased consciousness
• Death

Prevention

To prevent intoxication, avoid consuming alcoholic beverages and using illicit substances. Adopt a healthy lifestyle by:

• Eating a balanced diet with plenty of vegetables and fruits
• Drinking at least 2 liters of water daily
• Engaging in physical activity such as exercise at least twice a week for 30 minutes
• Getting sufficient sleep
• Participating in positive activities
• Joining hobby-based communities to avoid exposure to illicit substances

When to see a doctor?

Symptoms of acute intoxication typically appear rapidly. If you find that a friend or family member has ingested or inhaled a harmful substance in large quantities, immediately take them to the emergency department for prompt treatment.

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