Propylene glycol toxicity caused by prolonged infusion of etomidate. Van de Wiele B, Rubinstein E, Peacock W, Martin N. Metabolic basis of ethylene glycol monobutyl ether (2-butoxyethanol) toxicity: role of alcohol and aldehyde dehydrogenases. American academy of clinical toxicology practice guidelines on the treatment of ethylene Glycol poisoning. 1977 39:39–49.īarceloux DG, Krenzelok EP, Olson K, Watson W. On the metabolic acidosis of ethylene glycol intoxication. The role of formic acid in the development of metabolic acidosis in the monkey and the reversal by 4-methylpyrazole. McMartin KE, Makar AB, Martin G, Palese M, Tephly TR. Human liver alcohol dehydrogenase: inhibition by pyrazole and pyrazole analogs. This process is experimental and the keywords may be updated as the learning algorithm improves. These keywords were added by machine and not by the authors. Fomepizole may also have clinical utility in treating similar intoxications, such as those of glycol ethers, diethylene glycol, and propylene glycol, as well as in ethanol-disulfiram interactions. Because of its high safety profile and ease of use in human patients, fomepizole has rapidly replaced ethanol for ADH-inhibitory therapy in methanol and ethylene glycol poisoning.
Fomepizole has demonstrated efficacy in vivo against the conversion of methanol and ethylene glycol to their toxic metabolites in animal models, where it reversed an already-developed metabolite accumulation and severe metabolic acidosis without dialysis. It is a potent inhibitor of alcohol dehydrogenase (ADH), with an affinity more than 1000 times that of the toxic alcohols. Fomepizole is the generic drug name for the chemical 4-methylpyrazole (4-MP) now widely available in Europe and North America for the treatment of methanol and ethylene glycol poisoning.
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