Saturday February 24, 2007
Ethylene Glycol poisoning - II

Continuing our theme from yesterday on Ethylene Glycol poisoning, actual antidote or first line therapy is Fomepizole (Antizol) with fewer side effects.

Fomepizole blocks alcohol dehydrogenase. Fomepizole is administered as 15 mg/Kg (up to 1 Gm) initially, then 10 mg/Kg q12h times four doses, and then 15 mg/Kg q12 hours until ethylene glycol level <10>

In patients who are symptomatic, hemodialysis should be considered. Hemodialysis efficiently clears ethylene glycol and toxic byproducts and corrects acidosis.

If the patient does receive dialysis, treatment with fomepizole or ethanol should continue to be provided so as to block the ongoing conversion of Ethylene Glycol to its toxic metabolites while dislysis is being preformed. Both fomepizole and ethanol will be dialyzed off and their dosing needs to be adjusted accordingly.


Bonus Pearl: Fomepizole can also be use as antidote in Methanol overdose.