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雑誌文献

総合診療29巻2号

2019年02月発行

文献概要

特集 意外な中毒、思わぬ依存、知っておきたい副作用—一般外来で!OTCも処方薬も! 【知っておきたい&深めておきたい中毒症・依存症】

深める!急性アルコール中毒

著者: 上田剛士1

所属機関: 1洛和会ヘルスケアシステム洛和会丸太町病院救急・総合診療科

ページ範囲:P.156 - P.162

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 救急外来において、最も多い中毒は急性アルコール中毒です。特に夜間や土日に多く、「当直中に避けては通れない疾患」とも言えます。一方で、あまりにコモンであるがゆえに、系統的に学ぶ機会が少ない一面もあります。本稿では、急性アルコール中毒について学術的に深めましょう。

参考文献

1)Norberg A, et al : Role of variability in explaining ethanol pharmacokinetics ; research and forensic applications. Clin Pharmacokinet 42(1) : 1-31, 2003. PMID 12489977
2)Jones AW : Evidence-based survey of the elimination rates of ethanol from blood with applications in forensic casework. Forensic Sci Int 200(1-3) : 1-20, 2010. PMID 20304569
3)Franke A, et al : Effect of ethanol and some alcoholic beverages on gastric emptying in humans. Scand J Gastroenterol 39(7) : 638-644, 2004. PMID 15370684
4)Mitchell MC Jr, et al : Absorption and peak blood alcohol concentration after drinking beer, wine, or spirits. Alcohol Clin Exp Res 38(5) : 1200-1204, 2014. PMID 24655007
5)Finch JE, et al : An assessment of gastric emptying by breathalyser. Br J Clin Pharmacol 1(3) : 233-236, 1974. PMID 22454953
6)Edelbroek MA, et al : Effects of erythromycin on gastric emptying, alcohol absorption and small intestinal transit in normal subjects. J Nucl Med 34(4) : 582-588, 1993. PMID 8455074
7)Klockhoff H, et al : Faster absorption of ethanol and higher peak concentration in women after gastric bypass surgery. Br J Clin Pharmacol 54(6) : 587-591, 2002. PMID 12492605
8)Minocha A, et al : Activated charcoal in oral ethanol absorption ; lack of effect in humans. J Toxicol Clin Toxicol 24(3) : 225-234, 1986. PMID 3723647
9)Marx JA : Rosen's Emergency Medicine ; Concepts and Clinical Practice, 5th ed. p. 2513, Mosby, Inc., St. Louis, 2002.
10)上田剛士,他:急性アルコール中毒の臨床的特徴とエタノール血中濃度の推定.洛和会病院医学雑誌25 : 45-49, 2014.
11)Sullivan JB Jr, et al : Lack of observable intoxication in humans with high plasma alcohol concentrations. J Forensic Sci 32(6) : 1660-1665, 1987 PMID 3430134
12)Olson KN, et al : Relationship between blood alcohol concentration and observable symptoms of intoxication in patients presenting to an emergency department. Alcohol Alcohol 48(4) : 386-389, 2013 PMID 23690233
13)Goding GS, et al : Gaze nystagmus and blood alcohol. Laryngoscope 96(7) : 713-717, 1986. PMID 3724319
14)Booker JL : End-position nystagmus as an indicator of ethanol intoxication. Sci Justice 41(2) : 113-116, 2001. PMID 11393940
15)Lennernäs H : Ethanol-drug absorption interaction ; potential for a significant effect on the plasma pharmacokinetics of ethanol vulnerable formulations. Mol Pharm 6(5) : 1429-1440, 2009. PMID 19655809
16)山田裕一:日本人のアルコール代謝酵素の遺伝的多形と飲酒行動および飲酒による健康障害の関係.金沢医科大学雑誌30(4) : 448-455, 2005.
17)Hahn RG, et al : ‘Overshoot' of ethanol in the blood after drinking on an empty stomach. Alcohol Alcohol 32(4) : 501-505, 1997. PMID 9269858
18)Jones AW : Ultra-rapid rate of ethanol elimination from blood in drunken drivers with extremely high blood-alcohol concentrations. Int J Legal Med 122(2) : 129-134, 2008. PMID 17572905
19)Lieber CS : Ethanol metabolism, cirrhosis and alcoholism. Clin Chim Acta 257(1) : 59-84, 1997. PMID 9028626
20)蓮村靖:アルコール代謝とアルコールカロリー(特集:人体のエネルギー代謝--代謝管理と運動療法の機構).最新医学54(1) : 105-111, 1999.
21)Whittington JE, et al : The osmolal gap ; what has changed? Clin Chem 56(8) : 1353-1355, 2010. PMID 20530730
22)Snyder H, et al : Accuracy of blood ethanol determination using serum osmolality. J Emerg Med 10(2) : 129-133, 1992. PMID 1607618
23)Purssell RA, et al : Derivation and validation of a formula to calculate the contribution of ethanol to the osmolal gap. Ann Emerg Med 38(6) : 653-659, 2001. PMID 11719745
24)Garrard A, et al : Validation of a pre-existing formula to calculate the contribution of ethanol to the osmolar gap. Clin Toxicol(Phila)50(7) : 562-566, 2012. PMID 22765358
25)Galvan LA, et al : Generation of an osmolality gap-ethanol nomogram from routine laboratory data. Ann Emerg Med 21(11) : 1343-1348, 1992. PMID 1416330
26)Carstairs SD, et al : Contribution of serum ethanol concentration to the osmol gap ; a prospective volunteer study. Clin Toxicol(Phila)51(5): 398-401, 2013. PMID 23641935
27)Osterloh JD, et al : Discrepancies in osmolal gaps and calculated alcohol concentrations. Arch Pathol Lab Med 120(7) : 637-641, 1996. PMID 8757467
28)Wrenn KD, et al : The syndrome of alcoholic ketoacidosis. Am J Med 91(2) : 119-128, 1991. PMID 1867237
29)Yokoyama M, et al : Alcoholic ketoacidosis and ketosis in the emergency room. Nihon Kyukyu Igakukai Zasshi 13(11) : 711-717, 2002.
30)Umpierrez GE, et al : Differences in metabolic and hormonal milieu in diabetic- and alcohol-induced ketoacidosis. J Crit Care 15(2) : 52-59, 2000. PMID 10877365
31)Hockenhull J, et al : Investigation of markers to indicate and distinguish death due to alcoholic ketoacidosis, diabetic ketoacidosis and hyperosmolar hyperglycemic state using post-mortem samples. Forensic Sci Int 214(1-3) : 142-147, 2012. PMID 21840144
32)Noor NM, et al : Alcoholic ketoacidosis ; a case report and review of the literature. Oxf Med case reports 2016(3) : 31-33, 2016. PMID 26949539
33)MacDonald L, et al : Lactic acidosis and acute ethanol intoxication. Am J Emerg Med 12(1) : 32-35, 1994. PMID 8285968

掲載誌情報

出版社:株式会社医学書院

電子版ISSN:2188-806X

印刷版ISSN:2188-8051

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