Abstract |
A 19-year-old woman was admitted 45 min after ethylene glycol (EG) ingestion. The initial serum EG concentration was 1.34 g/l (21.6 mmol/l), the anion gap 14.5, and the osmolal gap 24. Renal function was preserved (serum creatinine 75.1 micromol/l). As the patient was seen soon after poisoning, before the development of metabolic acidosis, therapy with 4-methylpyrazole (4-MP) was proposed as an antidote. 4-MP was administered via the intravenous route (7 mg/kg as loading dose, followed by 3.6, 1.2, 0.6, and 0.6 mg/kg at intervals of 12 h). 4-MP alone was effective in preventing EG biotransformation to toxic metabolites (absence of metabolic acidosis and renal injury). Ethanol therapy, hemodialysis, and sodium bicarbonate administration were not required. The half-life of EG during 4-MP therapy was 11 h, with a mean EG renal clearance of 26.9 ml/min, and a total of 65.3 g EG was eliminated unchanged in the urine. 4-MP therapy was also well tolerated.
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Authors | P Hantson, A Hassoun, P Mahieu |
Journal | Intensive care medicine
(Intensive Care Med)
Vol. 24
Issue 7
Pg. 736-9
(Jul 1998)
ISSN: 0342-4642 [Print] United States |
PMID | 9722047
(Publication Type: Case Reports, Journal Article)
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Chemical References |
- Antidotes
- Pyrazoles
- Fomepizole
- Creatinine
- Ethylene Glycol
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Topics |
- Acid-Base Equilibrium
- Adult
- Antidotes
(therapeutic use)
- Biotransformation
- Creatinine
(blood)
- Ethylene Glycol
(metabolism, pharmacokinetics, poisoning)
- Female
- Fomepizole
- Humans
- Infusions, Intravenous
- Poisoning
(diagnosis, drug therapy)
- Pyrazoles
(therapeutic use)
- Time Factors
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