Alcohol

ALCOHOL

 

 

 

 

ALCOHOL

(BEER, WHISKEY, RUM, GIN, VODKA, BRANDY, WINES)

 

Preparation of Alcohol      Concentration of             Absolute alcohol                 Standard Drink

alcohol by volume(gms/100ml)

(%ABV)

Beer (standard)                     3-4                                             2.3-3.1                           300-400 ml.

Beer (strong)                        8-11                                            6.2-8.6                           100-150 ml.

Wines                                   5-13                                            3.9-10.1                         100-250 ml.

Fortified Wines                   14-20                                          10.9-15.9                         60-90 ml.

Spirits (Whiskey, Rum, Gin, Vodka, Brandy etc)    
                                             40                                              31.2                                30 ml.

   Arrack                                  33                                            25.7                                           40 ml

The acute effects that commonly occur at increasing blood alcohol concentrations (BAC)

 

< 80                Euphoria, feeling of relaxation and talking freely, clumsy movements of handsand legs, reduced alertness but believes himself to be alert.

>80                     Noisy, moody, impaired judgement, impaired driving ability

100-200             Electroencephalographic changes begin to appear, Blurred vision, unsteadygait, gross motor in-coordination, slurred speech, aggressive, quarrelsome,talking loudly.

200-300               Amnesia for the experience – blackout.

300-350               Coma

355-600May          cause or contribute to death

Danger sign: - fever, restrain required, tachycardia Alcoholic withdrawal are life threatening

DELIRIUM

  1. PSYCHOMOTOR ACTIVITY (patient is restless to the point might need to be tied to bed  )
  2. SLEEP (not slept for 2 to 3 days at a stretch )
  3. ATTENTION AND CONCERNTRATION
  4. CLOUDING OF CONCIOUSNESS(disoriented to time, place and person, hallucinations and illusions)
  5. EMOITONAL LAIBILITY ( fearful, crying, happy , anxious, aggressive and abusive)

 

 Acute alcohol intoxication
A.   The general criteria for acute intoxication are met.

B.   Dysfunctional behaviour, as evidenced by at least one of the following:
(1) disinhibition;
(2) argumentativeness;
(3) aggression;
(4) lability of mood;
(5) impaired attention;
(6) impaired judgement;
(7) interference with personal functioning.

C. At least one of the following signs:
(1) unsteady gait;
(2) difficulty standing;
(3) slurred speech;
(4) nystagmus;
(5) decreased level of consciousness (e.g. stupor, coma);
(6) flushed face,
(7) conjunctival injection.

Comment: Acute alcohol intoxication when severe may be accompanied by hypotension, hypothermia, and depression of the gag reflex. If desired, the blood alcohol level may be specified by using codes Y90.0 - Y90.8. Code Y91 may be used  to specify the clinical severity of intoxication, where the blood alcohol level is not available.

Pathological alcohol intoxication
Note:
The status of this condition is being examined. These research criteria must be regarded as tentative.
A.   The general criteria for acute intoxication (F1x.0) are met, with the exception that pathological intoxication occurs after drinking amounts of alcohol not sufficient to cause intoxication in most people.
B.   Verbally aggressive or physically violent behaviour that is not typical of the person when sober.
C.   Occurs very soon (usually a few minutes) after consumption of alcohol.
D.   No evidence of organic cerebral disorder or other mental disorders.

Comment : This is an uncommon condition. If blood alcohol levels are available, the levels found in this  disorder are lower than those which would cause acute intoxication in most people, i.e. below 40mg/100ml.

 

Alcohol withdrawal state
A.   The general criteria for withdrawal state (F1x.3) are met.

B.   Any three of the following:
(1) tremor of the outstretched hands, tongue or eyelids;
(2) sweating;
(3) nausea, retching or vomiting;
(4) tachycardia or hypertension;
(5) psychomotor agitation;
(6) headache;
(7) insomnia;
(8) malaise or weakness;
(9) transient visual, tactile or auditory hallucinations or illusions;
(10) grand mal convulsions.

Comment : If delirium is present, the diagnosis of alcohol withdrawal state with delirium ("delirium tremens") (F10.4) should be made.