DESCRIPTION

• Toxic alcohols discussed here include ethylene glycol, isopropyl alcohol, and methanol.
• Ethylene glycol is a sweet, odorless, colorless liquid, commonly used as automobile antifreeze solution as well as for other uses.
• Isopropyl alcohol is used as rubbing alcohol as well as in liquid soaps and for other uses.
• Methanol is wood alcohol used in windshield wiper fluid, Sterno^®, and other products.

GENERAL-PREVENTION

Poison proofing homes and giving parents poison prevention advice is the most effective way to prevent toxic alcohol exposures in children.

RISK-FACTORS

Toxicity via dermal absorption can occur in infants or young children with permeable skin.

PATHOPHYSIOLOGY

All toxic alcohols have direct effects as intoxicants. Ethylene glycol and methanol are metabolized to toxic by-products that result in severe morbidity or mortality.

• All toxic alcohols may result in CNS depression or coma. This coma may result in respiratory depression requiring ventilatory support.
• Ethylene glycol is metabolized to oxalic acid and glycolic acid, ultimately forming calcium oxalate crystals, which may precipitate in the renal tubules and cause renal failure.
• Methanol is metabolized to formaldehyde and then formic acid, which may damage the retina and cause visual impairment or blindness.
• The metabolism of ethylene glycol and methanol to their toxic metabolites may be prevented by competitively inhibiting alcohol dehydrogenase with either fomepizole or ethanol.
• Therapy to inhibit alcohol dehydrogenase is used for ethylene glycol and methanol exposure.
• Isopropyl alcohol is metabolized to acetone. Isopropyl alcohol may cause severe gastrointestinal irritation or hemorrhage.