S61(4) - Toxic Alcohol

Question 1

Isopropyl alcohol

Where is it found?

Answer 1

rubbing alcohol, hand sanitizer, paint removers, cements, cleaners

Question 2

Isopropyl alcohol

How much is consider toxic?

Answer 2

Prolonged intoxication
Isopropanol is 2x as intoxicating as ethanol
Example: Isopropanol 100 mg/dL = ethanol 200 mg/dL

Question 3

Isopropyl alcohol

What does toxicity look like?

Answer 3

Strong odor of acetone in the room
Urine dip strongly positive for ketones
Serum acetone is positive

Question 4

Isopropyl alcohol

How is it metabolized?

Answer 4

alcohol dehydrogenase to form acetone(ketone)

csn cause ketosis

Question 5

Isopropyl alcohol

What urgent treatment can we use, if any?

Answer 5

None

General supportive care
Hydration
Correct electrolytes

Question 6

Isopropyl alcohol

What are the antidotes?

Answer 6

NO ANTIDOTE AVAILABLE

Question 7

Isopropyl alcohol

What can be used as adjunct therapy?

Answer 7

None

Question 8

Acetone is not an acid
no direct anion gap acidosis (unless ketosis cause it)
but will elevate osmol gap
Interferes with serum creatinine measurement  might look elevated

Answer 8

true

Question 9

Although dialyzable, rarely used
Lethal doses
Coma
Refractory shock

Answer 9

true

Question 10

Isopropyl alcohol

Answer 10

no anion gap
only osmolar gap

normal osmolar gap = 10-20