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Isopropyl Alcohol Poisoning

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1. CRACKCast E147 – General Approach to the Poisoned Patient

syndrome, etc…) Poisons Toxic alcohols Inhaled toxins (e.g., carbon monoxide) Plant-derived toxins (e.g., Salvia) [5] List 6 T oxins T hat are R adiopaque Agents possibly radiopaque on plain x-ray: Substances with an atomic number >15 are more likely to be radiopaque (e.g., metals and halogenated hydrocarbons) Substances that are resistant to dissolution are more likely to be radiopaque (e.g., enteric coating or sustained-release formulations) As per UptoDate, use the mnemonic CHIPES! C – chlorinated (...) take a more refined approach. Below is a list of medications that can be directly measured in the blood in the toxicology patient. Acetaminophen Acetylsalicylic acid (salicylate) Carbamazepine Carbon monoxide Digoxin Ethanol Ethylene glycol Iron Isopropyl alcohol Lead Lithium Methanol Methotrexate Phenobarbital Phenytoin Valproic acid Refer to table 139.3 in Rosen’s 9 th Edition for a comprehensive description of the toxicological electrocardiogram manifestations of differed drug overdoses. [3

2018 CandiEM

2. CRACKCast E155 – Toxic alcohols

CRACKCast E155 – Toxic alcohols CRACKCast E155 – Toxic alcohols - CanadiEM CRACKCast E155 – Toxic alcohols In by Chris Lipp March 5, 2018 In this 155th episode of Crackcast is focused on toxic alcohols. There will be a special emphasis on ethanol, ethylene glycol and isopropyl alcohol. Shownotes – Key concepts Serum osmolarity = 2 salt and a sticky BUN. is calculated by the following equation: Calculated osmolality = (2 x Na) + Glucose + BUN + (1.25 x ETOH) The measured osmolar gap (...) isopropanol ingestion. Patients can have a prolonged period of inebriation and can be comatose. Alcohol dehydrogenase inhibition is not indicated in these cases. Hypotension and GI bleeding are poor prognostic factors in isopropanol ingestion. Diethylene glycol can result in acidosis and renal failure and should be managed similarly to ethylene glycol poisoning with fomepizole and early hemodialysis. Rosen’s In Perspective: Today we’ll discuss the two and one so-so toxic alcohol: focusing on methanol

2018 CandiEM

3. Toxic alcohol diagnosis and management: an emergency medicine review. (PubMed)

alcohol poisoning. Toxic alcohols classically refer to a group of alcohols not meant for ingestion. Methanol, ethylene glycol, and isopropyl alcohol are readily available in common hardware and household materials. Toxic alcohols are ingested for a variety of reasons including accidental exposures, intentional inebriation, homicide and suicide. The patient with an altered mental status or concerning history warrants consideration of this potentially deadly ingestion. Treatment considerations include (...) Toxic alcohol diagnosis and management: an emergency medicine review. Toxic alcohols are a group of substances containing a hydroxyl group not meant to be ingested. They are the cause of a significant number of accidental and non-accidental exposures. Toxic alcohol poisoning can be associated with a significant degree of morbidity and mortality if not promptly recognized and treated. This review describes the clinical presentation and an approach to the recognition and management for toxic

2018 Internal and emergency medicine

4. Author Correction: Toxic alcohol diagnosis and management: an emergency medicine review. (Full text)

and management for toxic alcohol poisoning. Toxic alcohols classically refer to a group of alcohols not meant for ingestion. Methanol, ethylene glycol, and isopropyl alcohol are readily available in common hardware and household materials. Toxic alcohols are ingested for a variety of reasons including accidental exposures, intentional inebriation, homicide and suicide. The patient with an altered mental status or concerning history warrants consideration of this potentially deadly ingestion. Treatment (...) Author Correction: Toxic alcohol diagnosis and management: an emergency medicine review. Toxic alcohols are a group of substances containing a hydroxyl group not meant to be ingested. They are the cause of a significant number of accidental and non-accidental exposures. Toxic alcohol poisoning can be associated with a significant degree of morbidity and mortality if not promptly recognized and treated. This review describes the clinical presentation and an approach to the recognition

2018 Internal and emergency medicine PubMed

5. Reported Adverse Health Effects in Children from Ingestion of Alcohol-Based Hand Sanitizers — United States, 2011–2014 (Full text)

Reported Adverse Health Effects in Children from Ingestion of Alcohol-Based Hand Sanitizers — United States, 2011–2014 Hand sanitizers are effective and inexpensive products that can reduce microorganisms on the skin, but ingestion or improper use can be associated with health risks. Many hand sanitizers contain up to 60%-95% ethanol or isopropyl alcohol by volume, and are often combined with scents that might be appealing to young children. Recent reports have identified serious (...) consequences, including apnea, acidosis, and coma in young children who swallowed alcohol-based (alcohol) hand sanitizer (1-3). Poison control centers collect data on intentional and unintentional exposures to hand sanitizer solutions resulting from various routes of exposure, including ingestion, inhalation, and dermal and ocular exposures. To characterize exposures of children aged ≤12 years to alcohol hand sanitizers, CDC analyzed data reported to the National Poison Data System (NPDS).* The major route

2017 MMWR. Morbidity and mortality weekly report PubMed

6. Naltrexone prevents delayed encephalopathy in rats poisoned with the sarin analogue diisopropylflurophosphate. (PubMed)

assigned to receive a single intraperitoneal (IP) injection of 5 mg/kg DFP (n = 12) or vehicle control (isopropyl alcohol, n = 5). Rats were observed for cholinesterase toxicity and treated with IP atropine (2 mg/kg) and pralidoxime (25 mg/kg) as needed. After resolution of acute toxicity, rats injected with DFP were again randomized to receive daily injections of naltrexone (5 mg/kg per day) or saline (vehicle control). Control animals also received daily injections of saline. For 4 weeks after acute (...) Naltrexone prevents delayed encephalopathy in rats poisoned with the sarin analogue diisopropylflurophosphate. Acute poisoning with organophosphate compounds can cause chronic neuropsychological disabilities not prevented by standard antidotes of atropine and pralidoxime. We determine the efficacy of naltrexone in preventing delayed encephalopathy after poisoning with the sarin analogue diisofluorophosphate (DFP) in rats.A randomized controlled experiment was conducted. Rats were randomly

2013 American Journal of Emergency Medicine

7. Toxicity, Alcohols (Diagnosis)

Emerg Med . 2018 Apr. 13 (3):375-383. . Jammalamadaka D, Raissi S. Ethylene glycol, methanol and isopropyl alcohol intoxication. Am J Med Sci . 2010 Mar. 339(3):276-81. . Hornfeldt CS. A report of acute ethanol poisoning in a child: mouthwash versus cologne, perfume and after-shave. J Toxicol Clin Toxicol . 1992. 30(1):115-21. . Martz W. A lethal ingestion of a household cleaner containing pine oil and isopropanol. J Anal Toxicol . 2010 Jan-Feb. 34(1):49-52. . Slaughter RJ, Mason RW, Beasley DM (...) is converted to acetyl Co A, and ultimately carbon dioxide and water. [ ] Genetic polymorphisms coding for alcohol dehydrogenase, the amount of alcohol consumed, and the rate at which ethanol is consumed all affect the speed of metabolism. As a general rule, ethanol is metabolized at a rate of 20-25 mg/dL in the nonalcoholic but at an increased rate in chronic alcoholics. Isopropanol Isopropyl alcohol (isopropanol; CH 3 -CHOH-CH 3 ) is a low molecular weight hydrocarbon. It is commonly found as both

2014 eMedicine Emergency Medicine

8. Toxicity, Alcohols (Treatment)

, Davis WT, Sessions DJ, Koyfman A. Toxic alcohol diagnosis and management: an emergency medicine review. Intern Emerg Med . 2018 Apr. 13 (3):375-383. . Jammalamadaka D, Raissi S. Ethylene glycol, methanol and isopropyl alcohol intoxication. Am J Med Sci . 2010 Mar. 339(3):276-81. . Hornfeldt CS. A report of acute ethanol poisoning in a child: mouthwash versus cologne, perfume and after-shave. J Toxicol Clin Toxicol . 1992. 30(1):115-21. . Martz W. A lethal ingestion of a household cleaner containing (...) both alcohols are metabolized by alcohol dehydrogenase, the treatment is the same, and differentiating which of the two toxic alcohols is responsible is not necessary before implementing treatment. [ ] The primary antidotal treatment of methanol or ethylene glycol involves blocking alcohol dehydrogenase. This enzyme can be inhibited by either ethanol or fomepizole. [ , , ] Toxic alcohol levels are frequently not immediately available. Thus, ideally, if methanol or ethylene glycol poisoning

2014 eMedicine Emergency Medicine

9. Toxicity, Alcohols (Overview)

Emerg Med . 2018 Apr. 13 (3):375-383. . Jammalamadaka D, Raissi S. Ethylene glycol, methanol and isopropyl alcohol intoxication. Am J Med Sci . 2010 Mar. 339(3):276-81. . Hornfeldt CS. A report of acute ethanol poisoning in a child: mouthwash versus cologne, perfume and after-shave. J Toxicol Clin Toxicol . 1992. 30(1):115-21. . Martz W. A lethal ingestion of a household cleaner containing pine oil and isopropanol. J Anal Toxicol . 2010 Jan-Feb. 34(1):49-52. . Slaughter RJ, Mason RW, Beasley DM (...) is converted to acetyl Co A, and ultimately carbon dioxide and water. [ ] Genetic polymorphisms coding for alcohol dehydrogenase, the amount of alcohol consumed, and the rate at which ethanol is consumed all affect the speed of metabolism. As a general rule, ethanol is metabolized at a rate of 20-25 mg/dL in the nonalcoholic but at an increased rate in chronic alcoholics. Isopropanol Isopropyl alcohol (isopropanol; CH 3 -CHOH-CH 3 ) is a low molecular weight hydrocarbon. It is commonly found as both

2014 eMedicine Emergency Medicine

10. Toxicity, Alcohols (Follow-up)

. Ethylene glycol, methanol and isopropyl alcohol intoxication. Am J Med Sci . 2010 Mar. 339(3):276-81. . Hornfeldt CS. A report of acute ethanol poisoning in a child: mouthwash versus cologne, perfume and after-shave. J Toxicol Clin Toxicol . 1992. 30(1):115-21. . Martz W. A lethal ingestion of a household cleaner containing pine oil and isopropanol. J Anal Toxicol . 2010 Jan-Feb. 34(1):49-52. . Slaughter RJ, Mason RW, Beasley DM, Vale JA, Schep LJ. Isopropanol poisoning. Clin Toxicol (Phila) . 2014 Jun (...) . Clin Toxicol (Phila) . 2005. 43 (5):327-45. . Gummin DD, Mowry JB, Spyker DA, Brooks DE, Fraser MO, Banner W. 2016 Annual Report of the American Association of Poison Control Centers' National Poison Data System (NPDS): 34th Annual Report. Clin Toxicol (Phila) . 2017 Dec. 55 (10):1072-1252. . . Kanny D, Brewer RD, Mesnick JB, Paulozzi LJ, Naimi TS, Lu H. Vital signs: alcohol poisoning deaths - United States, 2010-2012. MMWR Morb Mortal Wkly Rep . 2015 Jan 9. 63 (53):1238-42. . . Anderson P. WHO

2014 eMedicine Emergency Medicine

11. Alcohol

health and treatment. What is being tested? This test measures the amount of ethanol in the blood, urine, breath, or saliva. Ethanol (also called ethyl alcohol or alcohol) is the intoxicating ingredient in alcoholic beverages such as beer, wines and spirits. Small amounts of alcohol can cause excitement, relaxation, and decreased inhibition, but can also cause poor judgment and impaired eye-hand coordination; large amounts in a relatively short period of time can cause rapid alcohol poisoning (...) with confusion, slow breathing, coma, and even death. Consumption of large quantities of alcohol over a long period of time can lead to and to several medical problems such as permanent , cardiovascular problems, depression and anxiety. When alcohol is drunk, it is absorbed by the stomach and intestine, and carried throughout the body in the bloodstream. Small amounts of alcohol are removed by the kidney in urine or breathed out from the lungs, but most is broken down by the liver. Alcohol is poisonous

2012 Lab Tests Online UK

12. Specific Poisons

) Vomiting, dizziness, tinnitus, chills, tremor, delirium, seizures, respiratory depression, coma, methemoglobinemia Respiratory support, methylene blue for methemoglobinemia Roach poisons See Fluorides, Phosphorus, and Thallium salts — Rubbing alcohol See Alcohol, isopropyl — Salicylates See — Salicylic acid See — Scopolamine (hyoscine) See Belladonna — Secobarbital See Barbiturates — Selenium See Arsenic and Thallium salts — Sewer gas See Hydrogen sulfide — Silver salts Silver nitrate Stained lips (...) , respiratory depression Supportive care, IV glucose to prevent hypoglycemia Alcohol, isopropyl Rubbing alcohol Dizziness, incoordination, stupor to coma, gastroenteritis, hemorrhagic gastritis, hypotension Ketosis without acidosis No retinal injury or acidosis Supportive care, IV glucose, correction of dehydration and electrolyte abnormalities For gastritis, IV H 2 blockers or proton pump inhibitors Alcohol, methyl (methanol, wood alcohol) Antifreeze Paint solvent Solid canned fuel Varnish Severe toxicity

2013 Merck Manual (19th Edition)

14. Chlormethine (Ledaga) - mycosis fungoides-type cutaneous T-cell lymphoma

hydrochloride equivalent to 160 µg / g of chlormethine as active substance. Other ingredients are: diethylene glycol monoethyl ether, propylene glycol, isopropyl alcohol, glycerol, lactic acid, hydroxypropylcellulose, sodium chloride, menthol racemic, disodium edetate, and butylhydroxytoluene. The product is available in a white aluminium tube with an inner lacquer and an aluminium seal and a white polypropylene screw cap, as described in section 6.5 of the SmPC. 18 Osawa T, Davies D, Hartley JA. Mechanism (...) of the pharmaceutical development was to provide a non-greasy, chemically stable, single phase cutaneous presentation in which the active substance is held in solution, and which dries rapidly upon application to the skin. The active substance, chlormethine hydrochloride is known to be readily soluble in water and alcohols and therefore hydrophilic alcohol-based solvents were selected for the formulation in order to achieve a uniform Assessment report EMA/CHMP/653881/2017 Page 12/76 product. The physical

2017 European Medicines Agency - EPARs

15. Head lice

(Linicin ® Lotion); isopropyl myristate and cyclomethicone solution (Full Marks Solution ® ); and isopropyl myristrate and isopropyl alcohol aerosol (Vamousse ® Head Lice Treatment), all of which are available on the NHS. A chemical or traditional insecticide — these poison the lice by chemical means. In the UK, the only chemical insecticide that is currently recommended is Malathion 0.5% aqueous liquid (Derbac-M ® ), but resistance has been reported. Wet combing — this is the systematic combing of wet (...) studies, but it is uncommon and usually mild. Ovicidal activity is unknown. Isopropyl myristate and isopropyl alcohol (Vamousse ® , registered medical device) Advantages Largely physical action, so resistance is unlikely to develop. Disadvantages There is a lack of safety data on its use in pregnant or breastfeeding women or children younger than 2 years of age. CKS recommends Hedrin ® Lotion for use in these groups, as it is licensed for use in these groups [ ]. There is a lack of trial data for use

2016 NICE Clinical Knowledge Summaries

16. Duavive - oestrogens conjugated / bazedoxifene

, hydroxyethylcellulose, povidone (E1201), polydextrose (E1200), maltitol liquid, poloxamer 188, isopropyl alcohol and propylene glycol (E1520), as described in section 6.1 of the SmPC. The product is available in PVC/Aclar/PVC/Alu blister, as described in section 6.5 of the SmPC. Assessment report EMA/CHMP/383987/2014 Page 15/153 2.2.2. Active Substance Conjugated Oestrogens General information The “active substance” Conjugated Oestrogens is a mixture of different estrogenic substances isolated from pregnant mare’s

2015 European Medicines Agency - EPARs

17. Maximal Use Systemic Exposure Study of Levulan Kerastick (MUSE 2)

of the vehicle components (ethyl alcohol, isopropyl alcohol, laureth 4, polyethylene glycol) use of the following topical preparations on the extremities to be treated: Keratolytics including urea (greater than 5%), alpha hydroxyacids [e.g.glycolic acid, lactic acid, etc. greater than 5%], salicylic acid (greater than 2%) within 2 days of initiation of treatment Cryotherapy within 2 weeks of initiation of treatment Retinoids, including tazarotene, adapalene, tretinoin, retinol, within 4 weeks of initiation (...) or condition which could interfere with the evaluation of the test product or requires the use of interfering topical or systemic therapy significant blood loss within 60 days or donated blood/plasma within 72 hours prior to Visit 2 (Baseline) tested positive at screening for human immunodeficiency virus (HIV) or was known to be seropositive for HIV a history of lead poisoning or a history of a significant exposure to lead tested positive at screening for hepatitis B surface antigen, hepatitis C antibody

2015 Clinical Trials

18. Articles of the month (December 2015) (Full text)

critical appraisal of these methods. Bottom line: Watchful waiting may be reasonable for children with hard candies in their noses. (In case you were wondering, I would happily take this chap as my doctor) Alcohol by mouth can make you vomit. On the other hand, alcohol in the nose… Beadle KL, Helbling AR, Love SL, April MD, Hunter CJ. Isopropyl Alcohol Nasal Inhalation for Nausea in the Emergency Department: A Randomized Controlled Trial. Annals of emergency medicine. 2015. PMID: This is a randomized (...) trial of a convenience sample of 80 adult patients presenting to the emergency department with a chief complaint of nausea and/or vomiting. Patients were instructed to inhale from a pad of either saline or isopropyl alcohol (the same wipes you would use on the skin before starting an IV) immediately, then 2 and 4 minutes later. Although investigators covered the label of the wipe, I’m pretty sure blinding was eliminated the instant the patient took a sniff. Nausea was measured on a scale of 0 to 10

2015 First10EM PubMed

19. MUSE Study of Levulan Kerastick

in an investigational drug or device study has received an investigational drug or been treated with an investigational device within 30 days prior to Visit 2 (Baseline) known sensitivity to one or more of the vehicle components (ethyl alcohol, isopropyl alcohol, laureth 4, polyethylene glycol) use of the following topical preparations on the extremities to be treated: Keratolytics including urea (greater than 5%), alpha hydroxyacids [e.g.glycolic acid, lactic acid, etc. greater than 5%], salicylic acid (greater (...) a history of lead poisoning or a history of a significant exposure to lead or a screening lead level above 6μg/dl tested positive at screening for hepatitis B surface antigen, hepatitis C antibody or had a history of a positive result positive drug screen at Screening Screening safety labs are clinically significant in the opinion of the investigator major surgery within 30 days prior to Visit 2 (Baseline) or plans to have surgery during the study Subject is immunosuppressed currently enrolled

2014 Clinical Trials

20. Trial to Test if Antibiotic Ointments & Cream Will Sting After Application on a Minor Wound After Tape Stripping Injury

. Condition or disease Intervention/treatment Phase Sting Drug: Saline Drug: Isopropyl Alcohol Drug: Pain Relieving Cream Drug: Antibiotic/Pain Relieving Ointment Drug: Original Ointment Drug: Pain Relief Ointment Not Applicable Detailed Description: The primary objective of this study is to assess the sting potential of single applications of over-the-counter (OTC) topical antibiotic ointments and cream compared to saline (negative control) and isopropyl alcohol (positive control) when applied to a tape (...) Actual Study Completion Date : March 2015 Resource links provided by the National Library of Medicine related topics: Arms and Interventions Go to Arm Intervention/treatment Placebo Comparator: Saline 0.9% Sodium Chloride Saline Solution (0.3 cc) Drug: Saline Other Name: Sterile 0.9% Sodium Chloride Saline Solution Placebo Comparator: Isopropyl Alcohol 70% Isopropyl Alcohol (0.3 cc) Drug: Isopropyl Alcohol Other Name: 70 % Isopropyl Alcohol Experimental: Pain Relieving Cream Neosporin® Plus Pain

2014 Clinical Trials

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