Toxic Alcohols

  title={Toxic Alcohols},
  author={J. Kraut and M. Mullins},
  journal={The New England Journal of Medicine},
Poisonings by the toxic alcohols (methanol, ethylene glycol, isopropanol, diethylene glycol, and propylene glycol) can cause cellular dysfunction and death,1 but symptoms may be nonspecific. Delays in diagnosis increase the risk of irreversible organ damage and death.2 In this review, we discuss the mechanisms of toxicity, methods available for diagnosis, and current recommendations for therapy. 

Paper Mentions

A Case Report of Isopropanol Ingestion During the SARS-CoV-2 Pandemic
Toxic alcohol ingestions are imperative considerations on the differential for the intoxicated patient particularly during resource-limited times during the SARS-CoV-2 pandemic. Expand
The Diagnosis and Management of Toxic Alcohol Poisoning in the Emergency Department: A Review Article
The range of clinical presentations seen with poisonings by the major toxic alcohols--methanol, ethylene glycol, and isopropyl alcohol are discussed, including a straightforward diagnostic strategy and the current treatment recommendations. Expand
Spurious point-of-care lactate elevation in ethylene glycol intoxication: rediscovering a clinical pearl
This case highlights the importance of recognising a falsely elevated lactate, which should raise clinical suspicion of ethylene glycol poisoning, as the treatment is time-sensitive to prevent complications and mortality. Expand
Outcomes After Recurrent Intentional Methanol Exposures Not Treated With Alcohol Dehydrogenase Inhibitors Or Hemodialysis.
Following recurrent, intentional methanol exposure, isolated serum meethanol concentrations as high as 35 mg/dL (11 mmol/L) appear to be well-tolerated without treatment in the absence of metabolic acidosis or end-organ toxicity. Expand
Peripheral polyneuropathy after acute methanol poisoning: six-year prospective cohort study.
No association was found between the severity of acute methanol poisoning and the prevalence of PNP and its dynamics during six years of observation, and there was not an association between meethanol-induced visual/ brain damage and the prevalent PNP in survivors of poisoning. Expand
Serious Adverse Health Events, Including Death, Associated with Ingesting Alcohol-Based Hand Sanitizers Containing Methanol — Arizona and New Mexico, May–June 2020
CDC and state partners established a case definition of alcohol-based hand sanitizer-associated methanol poisoning and reviewed 62 poison center call records from May 1 through June 30, 2020, to characterize reported cases. Expand
Renal replacement therapy in the management of intoxications in children: recommendations from the Pediatric Continuous Renal Replacement Therapy (PCRRT) workgroup
Recommendations concerning the use of RRTs for treatment of intoxications with toxic alcohols, lithium, vancomycin, theophylline, barbiturates, metformin, carbamazepine, methotrexate, phenytoin, acetaminophen, salicylates, valproic acid, and aminoglycosides are presented. Expand
Detecting methanol in hand sanitizers
A low-cost, handheld, and smartphone-assisted device that detects methanol selectively in sanitizers between 0.01 and 100 vol% within two minutes, which meets an urgent need for on-site meethanol screening by authorities, health professionals, and even laymen. Expand
Adverse drug reactions: five historical scandals
This work aims to demonstrate the importance of knowing the carrier and removal status of canine coronavirus, as a source of infection for other animals, not necessarily belonging to the same breeds. Expand
AKI in a Patient Engaged in Vegetable Juicing
### Case Description A 68-year-old man with a past medical history of diabetes mellitus, hypertension, and achalasia presented to the emergency department with nausea and vomiting about 6–8 timesExpand


Antidotes for poisoning by alcohols that form toxic metabolites.
Fomepizole has largely replaced ethanol as the toxic alcohol antidote in many countries, Nevertheless, ethanol remains an important alternative because access to fome pizole can be limited, the cost may appear excessive, or the physician may prefer ethanol due to experience. Expand
Intravenous 4-methylpyrazole as an antidote for diethylene glycol and triethylene glycol poisoning: a case report.
A young female suicidally ingested DEG and TEG was presented in metabolic acidosis with coma, given 4-methylpyrazole (4-MP), an ADH inhibitor, the acidosis resolved, the patient recovered and was discharged without sequelae. Expand
Treatment of the alcohol intoxications: ethylene glycol, methanol and isopropanol
Fomepizole, an inhibitor of alcohol dehydrogenase, slows the metabolism of these substances and is now approved by the US Food and Drug Administration for use in ethylene glycol intoxication. Expand
Ethylene glycol poisoning: toxicokinetic and analytical factors affecting laboratory diagnosis.
This Case Conference integrates discussion of the toxicokinetic and analytical variables that affect the laboratory diagnosis of ethylene glycol intoxication. Expand
Fomepizole for ethylene glycol and methanol poisoning.
  • J. Brent
  • Medicine
  • The New England journal of medicine
  • 2009
A 35-year-old man is brought to the emergency department after ingesting automobile antifreeze. His pH is 7.30, and his urinalysis reveals calcium oxalate crystals, findings consistent with ethyleneExpand
Reviews: Recognition, Treatment, and Prevention of Propylene Glycol Toxicity
Although it is considered safe, large intravenous doses given over a short period of time can be toxic, underlying renal insufficiency and hepatic dysfunction raise risk for toxicity. Expand
Diagnosis of toxic alcohols: limitations of present methods
  • J. Kraut
  • Chemistry, Medicine
  • Clinical toxicology
  • 2015
Developing more rapid and effective tests for detection of these intoxications is essential for optimal care of patients and to examine the value and limitations of present methods to diagnose patients with possible toxic alcohol exposure. Expand
Ethylene glycol or methanol intoxication: which antidote should be used, fomepizole or ethanol?
There are two antidotes used to block ADH-mediated metabolism of EG and methanol: ethanol and fomepizole, and the advantages and disadvantages in terms of efficacy, safety and costs are discussed in order to help the physician to decide which antidote is appropriate in a specific clinical setting. Expand
Simple diagnostic tests to detect toxic alcohol intoxications.
These tests are sensitive, and they have different specificity for each of the alcohols facilitating distinction among them, and the relatively high sensitivity and specificity of the tests as a whole will facilitate the rapid diagnosis of each of these alcohol intoxications. Expand
Challenges in the diagnosis of ethylene glycol poisoning
There are several surrogate markers that can give an indication of ethylene glycol exposure but these must be interpreted with caution and within the clinical context, and an in-depth review of these tests will form the main focus of this article. Expand