The data obtained thus prove the effectiveness of enteral sorption with Enterosgel in the treatment of alcohol intoxication and withdrawal syndrome. Improvement in basic biological indicators was also observed.

Alcohol intoxication refers to the consequences of drinking characterized by appearance of reversible pathological mental, neurological and somatovegetative reactions associated with general toxic effects on the body, which is typically expressed by euphoria, sociability, relaxation and sedation. Effect of Enterosgel® depends on the time of its administration, the earlier Enterosgel is accepted, the more is the pronounced effect of its intake. Enterosgel is able to bind and excrete toxic products and endotoxins from the intestinal contents and blood (through the intestinal wall). Therefore, it is promising to study its efficiency in the treatment of patients with alcoholic liver disease (ALD).

There are three degrees of intoxication:

Mild intoxication causes festive mood, self-confidence, sense of comfort, increased activity, and cheerfulness. These symptoms are accompanied by pleasant physical sensations such as warmth and relaxation. Subsequently, fatigue grows, thinking becomes retarded, expressed judgments sound imprecise. At the same time, alongside with euphoric component, conflict and aggression may arise. At this level of intoxication, blood alcohol concentration is in the range of 50-150 mg/dL.

With an average degree of intoxication emotional and behavioral disorders are more pronounced as well as increased motor excitement, euphoria easily changes to irritability and can be even replaced by depression. Proneness to conflict becomes intensive, while impulses are disinhibited. Blood alcohol concentration at this level of intoxication is 150-250 mg/dL.

In case of severe intoxication profound disturbance of consciousness up to and including sopor or coma, lack of coordination of movements are developed, speech becomes completely slurred, association are jerky. When a patient recover from this state, amnesia is detected. Blood alcohol concentration in severe intoxication is 300-500 mg/dL. When the concentration of alcohol in the blood reaches a level of 600 mmol /l or more, death can occur.

Development of alcohol intoxication is caused by absorption of alcohol into the bloodstream from the gastrointestinal tract (GIT). [11] Absorption of alcohol starts in the oral cavity and extends to the stomach, and with the evacuation of stomach contents absorption continues in the proximal small intestine, mainly in the duodenum. In the distal small intestine a small portion of alcohol is absorbed. On an average about 20% of alcohol volume is absorbed in the stomach and the remaining 80% – in the small intestine. After absorption in the gastrointestinal tract, 80-90% of ethanol in the blood is metabolized in the cytoplasm of hepatocytes, and the rest undergoes biotransformation in the lungs, kidney, vascular endothelium and other tissues. Ethanol oxidation in the body occurs with alcoholdehydrohenase , whereby acetaldehyde is formed which is a highly toxic product that is subsequently oxidized to acetate . Acetaldehyde has a negative impact on a variety of biochemical processes: it violates most of the metabolic processes as well as negatively changes structure and functional activity of tissues. It is action of acetaldehyde that is a reason of a toxic effect of alcohol on the body.

In 2009,132 patients with alcoholic liver disease at the age from 25 to 65 years, of which 105 – men (57.7%) and 77 – women (42.3%) were examined. All patients were admitted to the hospitals in the acute stage of the disease. ALD diagnosis was confirmed by the information about the long-term (at least 2 years) regular alcohol consume. Application of intestinal adsorbent (enterosorbent) Enterosgel in patients with alcoholic liver disease (ALD) helps to reduce the lipid peroxidation (LPO) products – one of the main substrates of metabolic intoxication, which contributes to preservation of the natural functioning of cellular detoxification systems and antimicrobial resistance on subcompensated level and reduces the risk of auto-aggressive reactions.

I n 1990, Enterosgel detoxification effects were examined together with total detoxification in 18 patients intoxicated with alcohol.

The efficacy was evaluated using Enterosgel according to the criteria:

I. Dynamics of clinical indicators

II. Dynamics of laboratory indicators

III. The volume of drug therapy

Clinical indicators: psychosomatic status, tendency to alcohol abuse, sleep, appetite, sobering rate, reduction of withdrawal symptoms, subjective evaluation of patient condition.

Laboratory markers: bilirubin, ALT, AST, thymol turbidity.

When treating patients of the main group receiving Enterosgel, reduce of intoxication and withdrawal symptoms was observed during the first 24 hours. The next day most patients felt satisfactorily, the appetite returned, the patients did not feel the need to drink alcohol. Withdrawal syndrome proceeded much more slowly, intensive psychotropic therapy was not necessary, while a part of patients after infusion therapy experienced drowsiness and retreating tenseness. Patients of the main group did not experienced deterioration by evening, which was typical for the control group and was probably related to sub-absorption of alcohol, which remained in gastrointestinal tract.

The volume of drug treatment was different for each group. The average volume of infusion therapy was of 1.2 liters per 24 h. in the main group; in the control group – 2.0 liters per 24 hours. The ratio of volumes necessary and psychotropic and somatotropic drugs in the groups was about 1: 2, i.e. the main group needed twice less medication for normalization of homeostasis.

The data obtained thus prove the effectiveness of enteral sorption with Enterosgel in the treatment of alcohol intoxication and withdrawal syndrome. Improvement in basic biological indicators was also observed.

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1990, CLINICAL REPORT: USE OF ENTEROSGEL IN THE TREATMENT OF ALCOHOL INTOXICATION AND ITS CONSEQUENCES

Kajdaulova A.B., Vasilenko I.V.

Recently, the most challenging problem of narcology is treatment of alcohol intoxication, removal of drunkenness and reduction of withdrawal syndrome.

Open

EVIDENCE

1. SCIENTIFIC REPORT
“Study of the character of influence of the drug Enterosgel ® on severity of intoxication in healthy individuals”St. Petersburg, 2014 Open
Study director: Head of the Department of Internal Medicine propaedeutics, MD, Professor Tkachenko E.I.
Responsible person: Professor of the Department of Internal Medicine propaedeutics, MD Avalueva E.B.

2. REPORT: METABOLIC INTOXICATION AND ITS CORRECTION IN PATIENTS WITH ALCOHOLIC LIVER DISEASE Open
Osadchaya O.I., Shmatova E.A., Boyarskaya A.M.
Institute of Haematology and Transfusiology AMS Ukraine, Kiev, Ukraine, 2009

3. CLINICAL REPORT: USE OF ENTEROSGEL IN THE TREATMENT OF ALCOHOL INTOXICATION AND ITS CONSEQUENCES Open
Kajdaulova A.B., Vasilenko I.V.
Center for Medical and social problems of drug abuse, Kustanaj, Russia, 1990