**Question:** A 39-year old carpenter has taken two bottles of liquor from the local shop. After about an hour he develops confusion, vomiting and blurring of vision. He has been brought to the emergency outpatient. He should be given:

A. ANSWER: D.

**Core Concept:** Acute alcohol poisoning is a clinical syndrome caused by excessive alcohol intake, characterized by altered mental status, vomiting, and visual disturbances. The rapid onset of symptoms suggests a toxic substance ingestion.

**Why the Correct Answer is Right:** Alcohol poisoning is a consequence of the toxic effects of alcohol on the central nervous system (CNS). As alcohol levels in the bloodstream rise, it interferes with the neurotransmitter transmission in the brain, leading to impaired cognitive function, motor coordination, and visual acuity. In this scenario, the patient has consumed excessive alcohol (two bottles) and presents with the clinical manifestations of acute alcohol poisoning.

**Why Each Wrong Option is Incorrect:**

A) Option A: This option is incorrect as the patient has already consumed a toxic substance (alcohol) which is causing the symptoms.
B) Option B: This option is incorrect as it does not address the specific toxic substance causing the patient's symptoms (alcohol).
C) Option C: This option is incorrect as it does not directly address the underlying toxic substance causing the patient's symptoms.
D) Option D: Administering oxygen is important in managing any acute medical condition, including alcohol poisoning. However, this option does not address the toxic substance (alcohol) causing the patient's symptoms, which is the primary issue.

**Clinical Pearl:** In cases of acute alcohol poisoning, the primary management involves addressing the toxic substance (alcohol) causing the symptoms. Therefore, the correct answer is D - administering naloxone, which is an opiate antagonist used to counteract the effects of opiates and other depressants on the CNS. While administering oxygen is essential in managing acute illnesses, it does not directly address the toxic substance causing the patient's symptoms.