Pharmacological treatment of acute alcohol intoxication: More doubts than certainties

Petrolini, Valeria Margherita; Locatelli, Carlo

doi:10.1016/j.ejim.2023.01.010

Cited by 5 publications

(4 citation statements)

References 12 publications

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“…We conclude that ES is the first and only out-of-hospital service that a percentage of patients, 35.04% before the pandemic and 41.17% during the pandemic, will make use of in an alcohol-related emergency because they refuse to be admitted to the ED. Therefore, it is important to ensure the engagement of clinicians and nurses through telemedicine/telehealth to screen patients, particularly minors, with acute alcohol intoxication for underlying alcohol use disorders, and to implement a multidisciplinary program to assist in reducing excessive drinking through combined psychosocial and pharmacological interventions [19][20][21].…”

Section: Discussionmentioning

confidence: 99%

Reduced Pharmacological Intervention of Prehospital Services for Acute Alcohol Intoxication during the COVID-19 Pandemic in a Large District of Southern Italy

Giustino,

Natola,

Savoia

et al. 2024

Preprint

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Stress during a pandemic increased the risk of alcohol consumption, which may require pharmacological management. The characteristics of emergency calls for alcohol-related issues for patients pharmacologically treated, admitted to, or not admitted to the emergency department (ED) were analyzed. An observational single-center retrospective study was conducted from January 1, 2018 to December 31, 2021, and divided into 2-year periods (2018–2019 and 2020–2021). This study focused on calls to one of the EDs of seven hospitals in the Bari (Italy) metropolitan area for patients requiring emergency services (ES) who were either admitted or not admitted, due to their refusal. A 30% reduction in emergency calls for alcohol-related issues and a 41.17% reduction in calls for patients who refused to be admitted to the ED were observed during the pandemic. During the pandemic, a reduced rate of pharmacological treatment for calls coded green (non-critical), and an increase in calls coded yellow (fairly critical) and red (very critical) were recorded. Metadoxine was administered in almost all alcohol-related emergencies, primarily in conjunction with drugs acting on the gastrointestinal tract, irrespective of age, the period considered, and whether patients were admitted or not admitted to the ED. ES is the first and only out-of-hospital service encountered by numerous patients with alcohol-use disorders who refuse to be admitted to the ED. These patients should be directed by ES personnel to a multidisciplinary program to receive treatment for drinking, improve their quality of life, and reduce sanitation costs.

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Section: Discussionmentioning

confidence: 99%

Reduced Pharmacological Intervention of Prehospital Services for Acute Alcohol Intoxication during the COVID-19 Pandemic in a Large District of Southern Italy

Giustino,

Natola,

Savoia

et al. 2024

Preprint

View full text Add to dashboard Cite

show abstract

“…We conclude that the ES is the first and only out-of-hospital service that a percentage of patients, 35.04% before the pandemic and 41.17% during the pandemic, will make use of in an alcohol-related emergency because they refuse to be admitted to the ED. Therefore, it is important to ensure the engagement of clinicians and nurses through telemedicine/telehealth to screen patients, particularly minors, with acute alcohol intoxication for underlying alcohol-use disorders, and to implement a multidisciplinary program to assist in reducing excessive drinking through combined psychosocial and pharmacological interventions [ 19 , 20 , 21 ].…”

Section: Discussionmentioning

confidence: 99%

Reduced Pharmacological Intervention of Prehospital Services for Acute Alcohol Intoxication during the COVID-19 Pandemic in A Large District of Southern Italy

Giustino,

Natola,

Savoia

et al. 2024

JCM

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Background Stress during a pandemic increases the risk of alcohol consumption, which may require pharmacological management. Methods An observational single-center retrospective study was conducted from 1 January 2018 to 31 December 2021, and divided into 2-year periods (2018–2019 and 2020–2021). This study focused on calls to one of the emergency departments (EDs) of seven hospitals in the Bari (Italy) metropolitan area for patients requiring emergency services (ESs) who were either admitted or not admitted, due to their refusal. Results A 30% reduction in emergency calls for alcohol-related issues and a 41.17% reduction in calls for patients who refused to be admitted to the ED were observed during the pandemic. During the pandemic, an inverse association was found between pharmacological treatment and number of calls coded green (non-critical) and yellow (fairly critical) in patients admitted to EDs. An inverse association was also found for calls coded green in patients not admitted to EDs and pharmacological treatment. Metadoxine was administered in almost all alcohol-related emergencies, primarily in conjunction with drugs acting on the gastrointestinal tract, irrespective of age, the period considered, and whether patients were admitted or not admitted to the ED. Conclusions ES is the first and only out-of-hospital service encountered by numerous patients with alcohol-use disorders who refuse to be admitted to the ED. These patients should be directed by ES personnel to a multidisciplinary program to receive treatment for drinking, improve their quality of life, and reduce sanitation costs.

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“…Como se ha expuesto previamente, su uso no está indicado en el tratamiento de la intoxicación alcohólica aguda [6][7][8] . No obstante, hay autores que defienden que, en caso de intoxicación moderada o grave, las intoxicaciones alcohólicas agudas pueden tratarse con sueroterapia, dex-trosa, tiamina y ácido fólico 9 . Si bien es probable que no se haga daño al paciente con la administración de tiamina, ya que los efectos adversos descritos son escasos 10 , creemos que debe evitarse su uso generalizado.…”

Section: Discussionunclassified

Thiamine in acute alcohol poisoning

Supervía,

Fortea,

Palomino

et al. 2024

Rev Esp Urg Emerg

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INTRODUCCIÓN. La tiamina es un fármaco indicado en el tratamiento y prevención de la encefalopatía de Wernicke, que debe administrarse en caso de alcoholismo crónico o de malnutrición. Se evaluó el uso de la tiamina durante la asistencia de pacientes con intoxicación alcohólica aguda y si éste era adecuado. MATERIAL Y MÉTODOS. Estudio retrospectivo de todos los pacientes atendidos en el servicio de urgencias de un hospital universitario por intoxicación alcohólica aguda durante el año 2021. Se recogieron datos de filiación, forma de acceso a urgencias, lugar e intención de la intoxicación, antecedentes psiquiátricos y de intoxicaciones previas, clínica y consumo concomitante de otros tóxicos. Los pacientes se dividieron en dos grupos según se había administrado tiamina o no, se determinó si la indicación era correcta y se evaluó la presencia de factores asociados a su administración. RESULTADOS. Se atendieron 341 pacientes. Se administró tiamina en 98 casos (28,7%). En 78 (79,6%) estaba correctamente indicada. Los pacientes a los que se les administró eran de mayor edad [42,9 (13,6) vs 34,1 (15,3) años; p < 0,001] y preferentemente varones (36,6% vs 15,2%; p < 0,001). Una puntuación inferior a 9 en la escala de Glasgow se asoció al uso de tiamina (52,9% vs 26,8%; p = 0,027), así como la existencia de intoxicaciones previas (79,6% vs 44%, p < 0,001) y de antecedentes psiquiátricos (29,6% vs 18,5%; p = 0,025). CONCLUSIONES. La tiamina se administra en más de una cuarta parte de las intoxicaciones alcohólicas, la mayoría de forma correcta. La edad, el sexo masculino y los antecedentes de patología psiquiátrica y de intoxicaciones previas se asocian a su uso

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Pharmacological treatment of acute alcohol intoxication: More doubts than certainties

Cited by 5 publications

References 12 publications

Reduced Pharmacological Intervention of Prehospital Services for Acute Alcohol Intoxication during the COVID-19 Pandemic in a Large District of Southern Italy

Reduced Pharmacological Intervention of Prehospital Services for Acute Alcohol Intoxication during the COVID-19 Pandemic in a Large District of Southern Italy

Reduced Pharmacological Intervention of Prehospital Services for Acute Alcohol Intoxication during the COVID-19 Pandemic in A Large District of Southern Italy

Thiamine in acute alcohol poisoning

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