The lethal ethanol dose for adults is about 3 to 5 g/kg in adults, corresponding to a lethal serum concentration of 110 to 180 mmol/l (5-8 g/l), and is lowest among chronic alcoholics with poor nutrition. Fatalities are often related to alcohol-induced organ complications such as cardiomyopathy, malnutrition, and secondary infections.
Typical features of ethanol intoxication are central nervous system depression, hypotension, hypothermia, and respiratory problems, including aspiration of vomit into the lungs.
As ethanol replaces normal calories in chronic alcohol abusers, ketoacidosis (alcoholic acidosis) may develop when the blood ethanol level is zero or close to zero. If pronounced ketoacidosis occurs, methanol poisoning can be excluded by a normal ophthalmoscopy and ethylene glycol poisoning by lack of renal failure and characteristic urine sediment (see later).
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