Ethylene glycol toxicity should be suspected in anyone who is severely ill after drinking an unknown substance, especially if they at first appear drunk and you can't smell alcohol on their breath. An overdose of ethylene glycol can damage the brain, lungs, liver, and kidneys.
Sources and route of human exposure
The general public are most likely to be exposed to ethylene glycol by dermal contact with antifreeze products containing ethylene glycol (1). Many cases of paediatric poisonings have occurred on accidental ingestion of ethylene-glycol-containing antifreeze (1).
If ethylene glycol poisoning is suspected, begin antidotal therapy empirically while awaiting confirmation. Antidotes are fomepizole and ethanol. B-vitamin therapy may be used as an adjunct to antidotal therapy.
Fomepizole treatment should be initiated immediately when ethylene glycol poisoning is suspected.
Administration of either intravenous ethanol or fomepizole, both of which competitively inhibit ethylene glycol metabolism by alcohol dehydrogenase and can prevent the production and accumulation of the toxic metabolites, can be used as an antidote.
Reports of fatalities following ingestion of ethylene glycol indicate that a volume of 150–1,500 mL consumed at one time may cause death. In humans, the lethal dose of ethylene glycol is estimated to be in the range of 1,400–1,600 mg/kg.
Ingestion of ethylene glycol leads to systemic toxicity beginning with CNS effects, followed by cardiopulmonary effects, and finally renal failure.
Will Alcohol Cure Antifreeze Poisoning? Alcohol can be used as an antidote for antifreeze poisoning. Pharmaceutical antidotes, like fomepizole and hemodialysis, are preferred by doctors.
Initial adverse health effects due to methanol poisoning include drowsiness, a reduced level of consciousness (CNS depression), confusion, headache, dizziness, and the inability to coordinate muscle movement (ataxia).
A safe maximum intravenous PG dose has not been reported in the literature. However, one study reported that serum levels of PG greater than 18 mg/dL can be toxic. Other investigators have shown that toxicity is most likely to occur when the serum PG concentrations exceed 25 mg/dL.
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