Paucis Verbis: The Toxic Alcohols

June 25, 2012, 1:41 pm

Over at Academic Life in Emergency Medicine, Michelle Lin as part of her excellent “Paucis Verbis” series has posted cards summarizing the presentation and management of toxicity from ethylene glycol, methanol, and isopropyl alcohol. These cards can be printed out for handy portable reference, or saved on a smart phone or tablet.

Some selected pearls from the posts:

Ethylene Glycol

  • the metabolites, not ethyelene glycol, cause acidosis and toxicity
  • ethylene glycol itself, not the toxic metabolites, cause increased osmolal gap


  • permanent blindness has occurred after ingestion of approximately 1 teaspoon of methanol
  • may consider withholding hemodialysis if instituting treatment with fomepizole (I would emphasize that to do this the patient must not have any metabolic acidosis or renal failure)

Isopropyl Alcohol

  • since the parent compound, not the metabolic acetone, causes toxicity, fomepizole is not indicated
  • in isopropyl alcohol toxicity urine ketones will be positive

These cards are well worth keeping on hand for easy access.

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