Version May 2024
| To obtain emergency consultation with a medical toxicologist, in the United States, call 1-800-222-1222 for the nearest regional poison control center. Contact information for poison control centers around the world is available at the WHO website and in the UpToDate topic on regional poison control centers (society guideline links). |
| Clinical and laboratory features |
| Patients with isopropanol toxicity generally present with an alteration in mental status similar to that seen in ethanol intoxication |
| Rarely, massive overdose may present with hemodynamic instability |
| Diagnostic evaluation |
| Fingerstick glucose, salicylate and acetaminophen levels, and an ECG should be obtained |
| Basic electrolytes (with calculation of anion gap), BUN and creatinine, serum and urine ketones, serum osmolality, and an arterial or venous blood gas should be obtained |
| Serum isopropyl alcohol level should be obtained if possible |
| Laboratory hallmarks of isopropanol poisoning include an elevated osmolal gap without an anion gap acidosis, and a severe ketonemia |
| Treatment |
| Most patients recover uneventfully with supportive care alone; gastrointestinal decontamination with activated charcoal is unnecessary |
| Profoundly intoxicated patients may require endotracheal intubation |
| Hypotension should be treated with intravenous crystalloid, followed by vasopressors if needed. Refractory hypotension (which is very rare) is an indication for hemodialysis. |
| Isopropanol does NOT cause a metabolic acidosis and is NOT associated with the significant toxicity that may be seen in methanol or ethylene glycol ingestions. Aggressive alkalinization and/or antidotal therapy with fomepizole or ethanol are NOT INDICATED in isolated isopropyl alcohol ingestions. |
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