# Acute Alcohol Intoxication

- Category: chronic
- Review status: reviewed (every claim checked against a document named on this page)
- 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 date: 2026-08

## Verified against

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

## Treatment metadata

- No drug therapy in primary care (Referral & Advice)

## Complete treatment card

```text
ACUTE ALCOHOL INTOXICATION
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
Review status: REVIEWED against the source listed above  (2026-08)

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
  Score   CAGE questionnaire - Is this drinking a problem?
  Source  StatPearls "Ethanol Toxicity" - disease-level clinical article
  Status  traced to the source above

1. NO DRUG THERAPY IN PRIMARY CARE (REFERRAL & ADVICE)    [1st line]
   Adult    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
   Peds     Children follow the same pathway: recognise and refer. No primary-care medicine is
            implied.
   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.
   Caution  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.
```

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