TOX 10 - Glycols and aldehydes Flashcards
Glycol toxicity
Nephrotoxicity - tubular necrosis
Hepatotoxic
Narcotic effect
Glycol therapy
No specific antidote
Gastric lavage with potassium permanganate
Symptomatic therapy against kidney damage
Aldehydes
Formaldehyde
Acetaldehyde
Paraldehyde
Metaldehyde
Glutaraldehyde
(FAP M(ore)?)
Formaldehyde effects and therapy
protein precipitation -> necrosis
therapy consists of decontamination, supportive therapy and gastric lavage
Acetaldehyde
Weak local irritable effect, cause necrosis
Paraldehyde
Not toxic
Metaldehyde
Metabolized into acetaldehyde
Causes local irritation (hemorraghic gastritis) and later CNS effects
Ethylene glycol is used in , toxicity route
industrial liquids like anti-freeze and hydraulic brake fluids.
Toxicity comes from ingestion of these fluids
Propylene glycol is
general considered safe
although most toxicity cases result from it being used as diluent for intravenous administration of benzodiazepines
Ethylene Glycol Overdose
○ Initially: Transient excitation, followed by CNS depression
○ After 2-14 hours: Severe metabolic acidosis (lactic acid produced during metabolism)
○ After 14 hours: Renal insufficiency with oxalate deposition in the renal tubules
■ Anion gap acidosis, osmolar gap, oxalate crystals in the urine
Ethylene glycol metabolism
○ The toxic mechanism of ethylene glycol poisoning is mainly due to its metabolites
○ Ethylene glycol is metabolized in the liver by alcohol dehydrogenase to glycolaldehyde, which is further oxidized to glycolic acid by aldehyde dehydrogenase
○ The increase in toxic metabolites first affects CNS, then the heart, and finally the kidneys
treatment of ethylene glycol overdose
● Treatment: Fomepizole
○ Alcohol dehydrogenase inhibitor
○ Usage will decrease toxic metabolites
aldehyde uses
Broad spectrum activity against microorganisms and viruses
They inactivate microorganisms by alkylating the amino and sulfhydryl groups of proteins and ring nitrogen atoms of purine bases
○ Used for disinfection and sterilization of instruments
○ Formaldehyde is also used in embalming fluid to preserve bodies
● Formaldehyde:
Strong smell, irritating to respiratory mucosa and eyes→ Contact dermatitis, asthma
○ Potential carcinogen
○ Ingestion of the fluid causes corrosive damage to the GI tract
○ It has also become popular to use as a drug due to its euphoric properties. Marijuana cigarettes are dipped into or laced with Formaldehyde → Referred to as “Smoking Wet”
○ Inhaling smoke from these cigarettes may cause lung injuries and even respiratory failure
Aldehydes Treatment of toxicity:
○ Based on advanced life support treatment
