pituitrin and Alcoholic-Intoxication

Topics: Alcoholic Intoxication; Animals; Central Nervous System Agents; Ethanol; Humans; Hyperbaric Oxygenation; Kinetics; Naloxone; Parasympathomimetics; Sympathomimetics; Thyrotropin-Releasing Hormone; Vasopressins; Vitamin B Complex

Topics: Acute Disease; Alcoholic Intoxication; Autonomic Nervous System; Blood Pressure; Body Temperature; Cardiovascular System; Electrocardiography; Ethanol; Heart; Humans; Time Factors; Vasopressins

Controversial results of fluid and electrolyte derangements in patients with moderate alcohol intoxication have been described. However, no information is available about severe alcohol intoxication. We investigated differences of hormonal disorders between alcohol-habituated and alcohol-naive subjects with severe ethanol intoxication. The hormonal derangements and recommendations on therapy of these patients are discussed. Thirty-three patients [10 alcohol-naive (group A) and 23 alcohol-habituated (group B) subjects] with severe alcohol intoxication (blood ethanol > 200 mg/dl) were selected for the study. Electrolytes and osmolarity of serum and urine, blood ethanol, vasopressin, renin, and aldosterone were determined on admission 2, 4, and 6 hr later. Fluid balance was calculated for each hour. All patients received isotonic saline solution according to urine production. Group A: On admission, serum osmolarity was increased (308 mOsmol/kg). Concomitantly, vasopressin level was elevated on admission (9.12 pg/ml). Increased serum osmolarity was correlated with elevated vasopressin levels (r = 0.8211; p < 0.005). Serum electrolytes, renin, and aldosterone values were within normal ranges. Group B: On admission, vasopressin level was significantly decreased (0.9 pg/ml), despite an elevated serum osmolarity (309 mOsmol/kg). Serum osmolarity remained high despite a sufficient fluid substitution. In addition, vasopressin level remained suppressed over the observation period. Aldosterone level was significantly increased on admission (319 ng/ml). Accordingly, serum sodium was increased from 142 to 148 mM/liter, and serum potassium was decreased from 3.9 to 3.4 mM/liter. Response to hyperosmolarity due to severe alcohol intoxication is different in alcohol-naive and alcohol-habituated subjects.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Adolescent; Adult; Alcoholic Intoxication; Alcoholism; Aldosterone; Ethanol; Female; Humans; Kidney Function Tests; Male; Middle Aged; Potassium; Renin; Sodium; Vasopressins; Water-Electrolyte Balance; Water-Electrolyte Imbalance

One purpose of this report is to illustrate that calculating the rate of excretion of osmoles in the urine can be of value in the differential diagnosis of hypernatremia and polyuria. A second purpose is to illustrate a clinical example where the osmolality of the urine did not reflect the lack of action of ADH. A patient with ethanol intoxication seemed to have central diabetes insipidus on clinical grounds. However, the osmolality of the urine was 287 mosm/kg H2O, a value which made this diagnosis unlikely. Since the concentration of ethanol in plasma was 119 mmol/L, we suspected that the urine contained an appreciable quantity of alcohol; this might obscure the lack of action of ADH. A study was performed to document the quantitative relationship between the concentrations of ethanol in plasma and urine. The concentration of ethanol in the urine was approximately 1.4-fold greater than in plasma. Using this correction factor, the osmolality of the urine adjusted for ethanol in the patient was only 120 mosm/kg H2O, a value more consistent with the diagnosis of central diabetes insipidus.

Topics: Adult; Alcoholic Intoxication; Artifacts; Diabetes Insipidus; Diagnosis, Differential; Diuresis; Ethanol; False Negative Reactions; Female; Humans; Hypernatremia; Osmolar Concentration; Pituitary Gland, Posterior; Polyuria; Urinalysis; Vasopressins

Topics: Alcoholic Intoxication; Aldosterone; Ammonium Chloride; Calcium; Caseins; Cortisone; Dietary Carbohydrates; Diuresis; Ethanol; Fructose; Galactose; Glomerular Filtration Rate; Glucose; Hormones; Humans; Insulin; Lactates; Lipids; Magnesium; Potassium; Pyruvates; Sodium; Tolbutamide; Vasopressins; Xylose

Topics: Alcoholic Intoxication; Blood Glucose; Diabetic Coma; Ethanol; Humans; Mathematics; Osmolar Concentration; Polyuria; Thirst; Urea; Vasopressins

Topics: Adult; Alcohol Oxidoreductases; Alcoholic Intoxication; Blood Specimen Collection; Ethanol; Female; Humans; Male; Microchemistry; Vasopressins

Topics: Alcoholic Intoxication; Calcium Metabolism Disorders; Child; Diabetes Insipidus; Diagnosis; Diuresis; Genetics, Medical; Histiocytosis, Langerhans-Cell; Humans; Kidney Diseases; Measles; Polyuria; Prednisone; Psychosomatic Medicine; Sarcoidosis; Syndrome; Thirst; Toxicology; Urine; Vasopressins; Whooping Cough