Isopropyl alcohol toxicity: Difference between revisions

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*Treatment is supportive.
*Treatment is supportive.
*No role for fomepizole or ethanol


Revision as of 04:39, 23 February 2016


  • 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

Differential Diagnosis

Sedative/hypnotic toxicity



  • Fingerstick glucose
  • Complete metabolic panel
  • Serum ketones
  • Serum Osmolality
  • Uinarlysis
  • VBG
  • Aspirin/Tylenol levels
  • ECG
  • Serum isopropyl alcohol level (if available)
  • Total CK


  • 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


  • Treatment is supportive.
  • No role for fomepizole or ethanol


  • Generally may be discharged once clinically sober.

See Also