Isopropyl alcohol toxicity: Difference between revisions
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*Lethal Dose: 4-8 g/kg or 250mL in average adult | *Lethal Dose: 4-8 g/kg or 250mL in average adult | ||
== Clinical Features == | ==Clinical Features== | ||
*CNS depression | *CNS depression | ||
**Similar to ETOH intoxication, but longer-lasting | **Similar to ETOH intoxication, but longer-lasting | ||
**Usually | **Usually peaks in first hour of ingestion | ||
*GI | *GI | ||
**[[Nausea/vomiting]] / [[abdominal pain]] / hemorrhagic gastritis | **[[Nausea/vomiting]] / [[abdominal pain]] / hemorrhagic gastritis | ||
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*[[Hypoglycemia]] (in malnourished pts) | *[[Hypoglycemia]] (in malnourished pts) | ||
== Differential Diagnosis == | ==Differential Diagnosis== | ||
*[[Starvation ketoacidosis]] | *[[Starvation ketoacidosis]] | ||
*[[Diabetic Ketoacidosis]] | *[[Diabetic Ketoacidosis]] | ||
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==Diagnosis== | ==Diagnosis== | ||
=== Work-Up === | ===Work-Up=== | ||
*Fingerstick glucose | *Fingerstick glucose | ||
*Complete metabolic panel | *Complete metabolic panel | ||
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*Total CK | *Total CK | ||
=== Evaluation === | ===Evaluation=== | ||
*Osmolal gap > 10; see [[Osmolal or Osmolar Gap]] | *Osmolal gap > 10; see [[Osmolal or Osmolar Gap]] | ||
*Absence of anion gap | *Absence of anion gap | ||
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*Creatinine may be falsely elevated d/t acetone interference w/ laboratory measurement of Cr | *Creatinine may be falsely elevated d/t acetone interference w/ laboratory measurement of Cr | ||
== | ==Management== | ||
* | *Treatment is supportive. | ||
=== | ==Disposition== | ||
*Generally may be discharged once clinically sober. | |||
* | |||
== | ==See Also== | ||
== References == | |||
==References== | |||
<references/> | |||
[[Category:Tox]] | [[Category:Tox]] | ||
Revision as of 04:38, 23 February 2016
Background
- Main component of rubbing alcohol
- Hallmark is osmolar gap without acidosis
- Metabolized to acetone, not to an acid
- Takes 30-60min for acetone to appear in blood; 3hr to appear in urine
- Lethal Dose: 4-8 g/kg or 250mL in average adult
Clinical Features
- CNS depression
- Similar to ETOH intoxication, but longer-lasting
- Usually peaks in first hour of ingestion
- GI
- Nausea/vomiting / abdominal pain / hemorrhagic gastritis
- Respiratory depression
- Hypotension
- Hypoglycemia (in malnourished pts)
Differential Diagnosis
- Starvation ketoacidosis
- Diabetic Ketoacidosis
- Inborn errors of metabolism
- Salicylate Toxicity
- Acetone ingestion
Sedative/hypnotic toxicity
- Absinthe
- Barbiturates
- Benzodiazepines
- Chloral hydrate
- Gamma hydroxybutyrate (GHB)
- Baclofen toxicity
- Opioids
- Toxic alcohols
- Xylazine toxicity
Diagnosis
Work-Up
- Fingerstick glucose
- Complete metabolic panel
- Serum ketones
- Serum Osmolality
- Uinarlysis
- VBG
- Aspirin/Tylenol levels
- ECG
- Serum isopropyl alcohol level (if available)
- Total CK
Evaluation
- Osmolal gap > 10; see Osmolal or Osmolar Gap
- Absence of anion gap
- Absence of metabolic acidosis
- Absence of serum beta hydroxybutyrate
- Presence of serum and urine ketones
- Consider other diagnosis if absent 2hr after ingestion
- Creatinine may be falsely elevated d/t acetone interference w/ laboratory measurement of Cr
Management
- Treatment is supportive.
Disposition
- Generally may be discharged once clinically sober.