Diagnosis

The clinical diagnosis of isopropanol intoxication can be made from central nervous system depression and acetone breath. The specificity of Ketostix (sensitive only for acetoacetate) is far too low to be of practical value.

Both isopropanol (17 mmol/l or 1 g/l; osmolal contribution, 18 mosmol/kgH 2O) and acetone will increase the osmolal gap. The anion gap is usually normal but may be slightly increased due to ketosis (and some lactate) in the alcoholic and lactate in the hypotensive patient.

Isopropanol is best determined by a standard gas chromatographic method where ethanol, methanol, and acetone are also determined. Assessment

The lethal dose is quite variably given as 1 to 4 ml/kg, i.e. about twice as toxic as ethanol.

Blood isopropanol levels in the range of 34 to 68 mmol/l (2-4 g/l) are often seen without complications other than coma and slight respiratory depression. Others have survived with levels as high as 95 mmol/l (5.6 g/l) although hemodialysis was neccessary. Elimination is mainly due to hepatic metabolism to acetone; the serum half-life of isopropanol is 6 to 7 h.

The typical patient will present with central nervous system depression, depressed respiration, gastritis with abdominal pain, and slight hypothermia. Aspiration pneumonia may be present, particularly if the patient is found outdoors. The very young and the most severe alcoholics may be hypoglycemic.

Alcohol No More

Alcohol No More

Do you love a drink from time to time? A lot of us do, often when socializing with acquaintances and loved ones. Drinking may be beneficial or harmful, depending upon your age and health status, and, naturally, how much you drink.

Get My Free Ebook


Post a comment