Editing Alcohol intoxication (section)

==Management==
Acute alcohol poisoning is a [[medical emergency]] due to the risk of death from [[respiratory depression]] or [[aspiration pneumonia|aspiration of vomit]] if vomiting occurs while the person is unresponsive. Emergency treatment strives to stabilize and maintain an open airway and sufficient breathing while waiting for the alcohol to metabolize. This can be done by removal of any vomit or, if the person is unconscious or has impaired [[Pharyngeal reflex|gag reflex]], intubation of the trachea.<ref>{{cite journal |last1=Devi |first1=G. |last2=Castro |first2=V. J. |last3=Huitink |first3=J. |last4=Buitelaar |first4=D. |last5=Kosten |first5=T. |last6=O'Connor |first6=P. |year=2003 |title=Management of Drug and Alcohol Withdrawal |journal=NEJM |volume=349 |issue=4 |pages=405–407 |doi=10.1056/NEJM200307243490420 |pmid=12878752}}</ref>

Other measures may include
* Administer the vitamin [[thiamine]] to prevent [[Wernicke–Korsakoff syndrome]], which can cause a [[seizure]] (more usually a treatment for chronic alcoholism, but in the acute context usually co-administered to ensure maximal benefit).
* [[Hemodialysis]] if the blood concentration is very high at >130 &nbsp;mmol/L (>600&nbsp;mg/dL)<ref>{{cite journal |last1=Adinoff |first1=B. |last2=Bone |first2=G. H. |last3=Linnoila |first3=M. |date=May 1988 |title=Acute ethanol poisoning and the ethanol withdrawal syndrome |journal=Medical Toxicology |volume=3 |issue=3 |pages=172–196 |doi=10.1007/BF03259881 |pmid=3041244 |s2cid=35315540}}</ref>
* Provide oxygen therapy as needed via nasal cannula or non-rebreather mask.
* Administration of intravenous fluids in cases involving [[hypoglycemia]] and [[electrolyte imbalance]].<ref>{{cite journal |last1=Piccioni |first1=A. |last2=Tarli |first2=C. |last3=Cardone |first3=S. |last4=Brigida |first4=M. |last5=D'Addio |first5=S. |last6=Covino |first6=M. |last7=Zanza |first7=C. |last8=Merra |first8=G. |last9=Ojetti |first9=V. |last10=Gasbarrini |first10=A. |last11=Addolorato |first11=G. |last12=Franceschi |first12=F. |date=2020-09-24 |title=Role of first aid in the management of acute alcohol intoxication: a narrative review |url=https://pubmed.ncbi.nlm.nih.gov/32965003/ |journal=European Review for Medical and Pharmacological Sciences |volume=24 |issue=17 |pages=9121–9128 |doi=10.26355/eurrev_202009_22859 |issn=2284-0729 |pmid=32965003 |s2cid=221862046 |quote="In case of severe intoxication (blood alcohol concentration >1 g/L), it is necessary to prevent and to treat the potentially lethal metabolic effects of alcohol libation (in particular in adolescents) and to accelerate alcohol elimination from blood. It is necessary to support with intravenous fluids, treat hypoglycemia, hypotension, hypothermia and electrolyte imbalance, administer complex B and C vitamins, and support ventilation when necessary. To accelerate the elimination of ethanol from blood (assisting a faster recovery of the patient), two possible strategies can be applied: to perform a gastric lavage within two hours after drinking a considerable amount of alcohol or to administer metadoxine (pyridoxol L-2-pyrrolidone-5-carboxylate) that may be capable of decreasing ethanol blood levels by accelerating the urinary elimination of ethanol and acetaldehyde. Hypoglycemia is fasting-related and develops more frequently in young people (because of a lower reserve of liver glycogen); it is necessary to administer intravenous 5% glucose solution or, if possible, to invite the patient to eat fructose-rich foods and complex carbohydrates. Other metabolic effects could be electrolyte imbalance such as hypokalemia, hypomagnesaemia, hypocalcemia which must be appropriately and individually treated and replaced."}}</ref>
* While the medication [[metadoxine]] may speed the breakdown of alcohol, use in alcohol intoxication requires further study as of 2017.<ref name=Jun2014/><ref name=Goh2017/> It is approved in a number of countries in Europe, as well as India and Brazil.<ref name="Goh2017">{{cite journal |last1=Goh |first1=ET |last2=Morgan |first2=MY |date=April 2017 |title=Review article: pharmacotherapy for alcohol dependence – the why, the what and the wherefore. |url=http://discovery.ucl.ac.uk/1542523/3/Morgan_MYM%20accepted%20for%20deposit%20Pharmacotherapy%20for%20Alcohol%20Dependence%20Jan%202017%20for%20APT.pdf |archive-url=https://web.archive.org/web/20180719014723/http://discovery.ucl.ac.uk/1542523/3/Morgan_MYM%20accepted%20for%20deposit%20Pharmacotherapy%20for%20Alcohol%20Dependence%20Jan%202017%20for%20APT.pdf |archive-date=19 July 2018 |url-status=live |journal=Alimentary Pharmacology & Therapeutics |volume=45 |issue=7 |pages=865–882 |doi=10.1111/apt.13965 |pmid=28220511 |doi-access=free |s2cid=5431337}}</ref>
Additional medication may be indicated for treatment of [[nausea]], [[tremor]], and [[anxiety]].