Following last week's Paucis Verbis card on calculating the osmolal gap, here is the first installment of the Toxic Alcohols cards. First up -- ethylene glycol. There are useful American Academy of Clinical Toxicologists recommendations on when to administer an antidote (fomipezole) and when to perform hemodialysis.
Here's a quick review of the metabolism of the different toxic alcohols. The parent compounds for ethylene glycol and methanol are innocuous and the metabolites are toxic.
Feel free to download this card and print on a 4'' x 6'' index card.
See other Paucis Verbis cards.
Dr. Leon Gussow's great review on The Poison Review and tips of a recent Annals of EM paper on identifying a small subset of patients with ethylene glycol who did well despite NOT receiving hemodialysis.
Kraut JA, Kurtz I. Toxic alcohol ingestions: Clinical features, diagnosis, and management. Clin J Am Soc Nephrol. 2008;3:208-225. Pubmed .
Jammalamadaka D, Raissi S. Ethylene glycol, methanol, and isopropyl alcohol intoxication. Am J Med Sci. 2010;339(3):276-281. Pubmed .
Marraffa JM, Cohen V, Howland MA. Antidotes for toxicological emergencies: a practical review. Am J Health-Syst Pharm. 2012;69:199-212. Pubmed .