{
  "schema_version": 1,
  "kind": "condition",
  "id": "acute-alcohol-intoxication",
  "name": "Acute Alcohol Intoxication",
  "category": "chronic",
  "sources": "Ethanol Toxicity - StatPearls - NCBI Bookshelf (NBK557381) - https://www.ncbi.nlm.nih.gov/books/NBK557381/ · MSF Essential Drugs 2024 (THIAMINE = VITAMIN B1 injectable monograph) - msf-essential-drugs-2024.txt · ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class PS13 - condition scope only, no dose",
  "review_status": "reviewed",
  "verified_against": "Ethanol Toxicity - StatPearls (NBK557381), treatment section - thiamine recommended, no amount stated · MSF Essential Drugs 2024, THIAMINE = VITAMIN B1 injectable - 100 mg IM or IV 3 times daily for 3 to 5 days",
  "verified_date": "2026-09",
  "treatments": [
    {
      "id": 30,
      "generic": "Thiamine",
      "line": 1,
      "is_adjunct": false,
      "form": "injection",
      "strength_mg": 100.0,
      "adult_dose": "100 mg by intramuscular injection, or by very slow intravenous injection over 30 minutes, 3 times daily",
      "adult_duration": "3 to 5 days",
      "dose_source": "MSF Essential Drugs 2024 (THIAMINE = VITAMIN B1 injectable monograph, delirium tremens and Wernicke's encephalopathy)",
      "rationale": "The Ethanol Toxicity article recommends routine thiamine for a patient with alcohol use disorder, especially where the mental status is altered, and states no amount; it reasons that occult thiamine deficiency and Wernicke encephalopathy are hard to detect and carry a high mortality, so the balance favours giving it. The amount comes from MSF, whose thiamine monograph doses exactly that picture. The two sources are named separately because they answer different questions - one says give it, the other says how much.",
      "cautions": [
        "Egypt's register lists no single-ingredient thiamine preparation, injectable or oral. Vitamin B1 appears only inside B-complex ampoules and tablets whose thiamine content the register does not state, so read the ampoule's own label before giving the amount above.",
        "Anaphylaxis and hypotension are reported with intravenous thiamine. The monograph requires a very slow intravenous injection over 30 minutes; the intramuscular route avoids that risk.",
        "Check a point-of-care glucose. Many patients with alcohol use disorder have depleted glycogen stores, and the Ethanol Toxicity article treats hypoglycaemia before replenishing vitamins such as thiamine.",
        "Thiamine treats the deficiency, not the intoxication. A reduced level of consciousness still needs emergency assessment."
      ],
      "peds_mgkg_low": null,
      "peds_mgkg_high": null,
      "peds_max_mg": null,
      "peds_basis": null,
      "peds_unit": null,
      "peds_note": "No source on file states a thiamine dose for a child with acute alcohol intoxication. MSF's paediatric thiamine amounts are written for infantile beriberi, which is a different illness, so none of them is printed here. A child who has drunk alcohol is referred.",
      "peds_min_weight_kg": null,
      "peds_max_weight_kg": null,
      "peds_age_min_months": null,
      "peds_age_max_months": null,
      "peds_age_bands": null,
      "peds_doses": null,
      "brands": [],
      "condition_id": "acute-alcohol-intoxication"
    },
    {
      "id": 31,
      "generic": "Observation, airway and glucose (Referral & Advice)",
      "line": 1,
      "is_adjunct": false,
      "form": null,
      "strength_mg": null,
      "adult_dose": "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.",
      "adult_duration": "Refer, with advice",
      "dose_source": "No dose - observation, airway protection and glucose, then referral",
      "rationale": "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.",
        "Ethanol itself has no antidote. Thiamine is given for the deficiency that goes with alcohol dependence, not to reverse the intoxication; the rest of the management is observation, airway protection and glucose.",
        "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."
      ],
      "peds_mgkg_low": null,
      "peds_mgkg_high": null,
      "peds_max_mg": null,
      "peds_basis": null,
      "peds_unit": null,
      "peds_note": "A child who has drunk alcohol follows the same pathway: recognise and refer. The thiamine amount printed above is an adult amount and no source states one for a child in this illness.",
      "peds_min_weight_kg": null,
      "peds_max_weight_kg": null,
      "peds_age_min_months": null,
      "peds_age_max_months": null,
      "peds_age_bands": null,
      "peds_doses": null,
      "brands": [],
      "condition_id": "acute-alcohol-intoxication"
    }
  ]
}