Dawaa Reference

chronic

Acute Alcohol Intoxication

Treatment options, dosing, cautions and Egyptian brands from the shipped Dawaa Reference card.

Evidence status

Checked against the sources named below

Sources3 sources

Ethanol Toxicity - StatPearls - NCBI Bookshelf - https://www.ncbi.nlm.nih.gov/books/NBK482121/ · ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class PS13 - condition scope only, no dose · No dose - referral pathway, no medicine given in primary care

Verified against1 document
  • No dose - referral pathway, no medicine given in primary care

Verified date2026-08

Presentation reference

Is it this?

Reference only, to read alongside your own examination.

Symptoms — what the patient reports (3)

  • Complains of nausea, vomiting and diarrhoea [diarrhoea · nausea · vomiting]
  • At low blood levels: relaxation, talkativeness, clumsy fine movements
  • Double vision and amnesia once blood alcohol climbs [double vision · memory loss]

Signs — what you find (8)

  • Slurred speech, clumsiness, nystagmus and memory loss support the diagnosis [memory loss · nystagmus · slurred speech]
  • Judgement and coordination become impaired as the level rises
  • Unsteady gait with slurred speech and mood or behaviour change [slurred speech]
  • Low body temperature, dysarthria and nystagmus at higher levels [hypothermia · nystagmus · slurred speech]
  • Above 0.4%, breathing is depressed and coma or death can follow [coma]
  • Skin signs include telangiectasia, spider naevi, palmar erythema and muscle wasting [muscle wasting · redness · telangiectasia]
  • Tolerance can leave a heavy drinker alert and steady at levels that would floor others
  • Re-examine: injuries may surface only as the intoxication wears off

Tests (7)

  • Full electrolyte panel plus liver function tests
  • Metabolic upsets include lactic acidosis and low glucose, potassium, magnesium, calcium and phosphate
  • ECG, since alcohol can set off atrial and ventricular tachydysrhythmias
  • Repeat the ECG if an arrhythmia is found; most settle as alcohol clears
  • Holiday heart syndrome, a new arrhythmia such as atrial fibrillation after a binge
  • Brain CT where the mental state is altered and no full history is obtainable
  • Psychiatric assessment, repeated when lucid, if suicidal talk or gestures occur

If not this — what else fits (6)

  • Head trauma, sepsis or central nervous system infection
  • Seizure, or poisoning by something other than ethanol
  • Too hot or too cold, thyroid disturbance, hypoxia, metabolic derangement
  • Non-beverage alcohol - cologne, cough syrup, isopropyl
  • Wernicke encephalopathy or hepatic encephalopathy, once drinking is established
  • Any of these can sit alongside the intoxication rather than replace it

Scores

  • CAGE questionnaire — Is this drinking a problem?

SourceStatPearls "Ethanol Toxicity" - disease-level clinical article

Presentation findings are traced to the source above.

1

NO DRUG THERAPY IN PRIMARY CARE (REFERRAL & ADVICE)

1st line
Adult dose and duration

Acute impairment from alcohol use presenting with disinhibition, poor coordination, or reduced consciousness; mild intoxication is observed until sober, while significant impairment of consciousness or suspected co-ingestion needs emergency assessment, since there is no specific antidote. - Refer, with advice

Paediatric dose

Children follow the same pathway: recognise and refer. No primary-care medicine is implied.

Dose source

No dose - referral pathway, no medicine given in primary care

Why

Acute impairment from alcohol use presenting with disinhibition, poor coordination, or reduced consciousness; mild intoxication is observed until sober, while significant impairment of consciousness or suspected co-ingestion needs emergency assessment, since there is no specific antidote.

Cautions
  • Rare in Egyptian primary care.
  • No medicine is prescribed for this in primary care - this entry is for recognition and referral. Anything given is decided by the service it is referred to.
  • RED FLAG - A reduced level of consciousness or an inability to protect the airway (aspiration risk) is an emergency. Refer also for signs of head injury or hypoglycaemia coexisting with the intoxication, or suspected co-ingestion of another drug.

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.