Isopropanol Poisoning

Basics

Description

  • CNS depressant effect of isopropanol is 2–3 times as potent as that of ethanol
  • Many products that contain isopropanol also contain methanol, ethylene glycol, and ethanol
  • Rapidly absorbed following oral ingestion
  • Ketogenic, but does not cause significant acidosis
  • Metabolized by alcohol dehydrogenase to acetone (a CNS depressant):
    • Concomitant ethanol ingestion doubles half-life of isopropanol but not that of acetone
    • Acetone eliminated by lung and kidney
  • Lethal dose: 250 ccs
  • Vd: 0.45–0.55 L/kg
  • Half-life:
    • Isopropanol: 2.5–8 hr
    • Acetone: 7.5–26 hr

Etiology

  • Isopropanol (isopropyl alcohol): Clear, colorless, volatile liquid with faint odor of acetone and bitter taste
  • Available as 70% rubbing alcohol solution:
    • May contain blue dye that was added to inhibit its abuse (“blue heaven”)
  • Found in:
    • Various toiletries
    • Disinfectants
    • Window-cleaning solutions
    • Paint remover
    • Solvents
    • Jewelry cleaners
    • Detergents
    • Antifreeze
    • Hand sanitizers
  • Typical adult patient: Chronic alcoholic who has been on drinking binge and recently depleted his or her ethanol supply
  • Dermal and rectal administration can cause systemic toxicity

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