Tox: Isopropanol

-rubbing alc, solvents, skin/hair products, paint thinners, antifreeze
-double potency and duration of etoh
-isoprop > liver > acetone > acetate and formate, but not enough to cause acidosis
si/sx - smell rubbing alc on breath, coma, resp depression, hypotn
-hemorrhagic gastritis is a char finding > n/v/abd pain/upper gi bleed
-also hepatic dysfxn, atn, rhabdo
-labs - ketones in blood & urine (from acetone), nl glc, absent or min acidosis, elevated osm gap
-*ketonemia, ketonuria, inc osm gap, w/min met acidosis
Management
-IVF
-FSBS
-thiamine
-naloxone if ams
-charcoal does not bind alcohols, but give if coingestion
-hemodialysis for refract hypotn or if predicted peak level of isoprop is >400 mg/dl
-labs: lytes, bun, cr, glc, isopropanol, acetone, u/a
Dispo
-if mild ingestion, asx, can d/c after 6-8hr of obs in ed