Page 422 - Basic _ Clinical Pharmacology ( PDFDrive )

408 SECTION V Drugs That Act in the Central Nervous System

C ASE STUD Y ANSWER

This young man exhibited classic signs and symptoms of acute trachea would be intubated, vomitus removed, and mechani-
alcohol poisoning, which is confirmed by the blood alcohol cal ventilation begun. Intravenous access would be obtained
concentration. We do not know from the case whether the and used to administer dextrose and thiamine, as well as elec-
patient was tolerant to the effects of alcohol but note that trolytes and vitamins. If a young, previously healthy individual
his blood alcohol concentration was in the lethal range for a receives medical care in time, supportive care will most likely
nontolerant individual. Death most likely resulted from respi- be highly effective. As the patient recovers, it is important to
ratory and cardiovascular collapse prior to medical treatment, be vigilant for signs and symptoms of the alcohol withdrawal
complicated by a chemical pneumonitis secondary to aspira- syndrome. (For a case involving chronic alcoholism and
tion of vomitus. The treatment of acute alcohol poisoning withdrawal management, see Nejad SH et al: Case 39-2012:
includes standard supportive care of airway, breathing, and A 55-year old man with alcoholism, recurrent seizures, and
circulation (“ABCs,” see Chapter 58). Most importantly, the agitation. N Engl J Med 2012;367:2428.)