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13. Intoxication and overdoses
Intoxication may be defined as the intake of a quantity of a substance which exceeds the individual's tolerance and produces behavioural or physical abnormalities.
Overdose may be defined as the state that occurs when a person has ingested a drug quantity higher than the recommended therapeutic dose and that also exceeds his/her tolerance.
Note: This section offers some guidelines, basic points and reminders, but is not a comprehensive manual for the management of overdosing and poisonings. When presented with an intoxicated or overdose patient basic ABC procedures should be followed.
In acute overdose it is recommended that patients are closely observed, monitored and referred to an acute care hospital.
A basic modern text on toxicology is Ellenhorn, M. and Barceloux, D.G. Medical toxicology: diagnosis and treatment of human poisoning, Elsevier, New York, 1988.
ALCOHOL INTOXICATION AND OVERDOSE
Clinically obvious alcohol intoxication occurs in non-tolerant individuals at blood alcohol levels of approximately 34 mmol/litre.
In alcohol-dependent persons marked tolerance to the behavioural effects of alcohol may develop. It is not unusual for such patients to appear unimpaired with a blood alcohol level of 60-70 mmol/litre.
Coma develops in most individuals when a blood alcohol level is 90-120 mmol/litre. If the blood alcohol level is less than 100 mmol/litre with a patient in coma or unconscious, another drug, concurrent brain injury or other disease should be suspected.
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