Management of Toxic Alcohol Poisoning

Introduction to Toxic Alcohol Poisoning

• The EXTRIP workgroup recommends extracorporeal treatment for ethylene glycol poisoning based on specific criteria including ethylene glycol concentration, osmol gap, and presence of metabolic acidosis 1

Antidotes for Toxic Alcohol Poisoning

• No valid information is available for this section.

Extracorporeal Treatment for Toxic Alcohol Poisoning

• Hemodialysis is a key element in severe poisoning, removing both parent compounds and toxic metabolites, as recommended by the EXTRIP workgroup 1

Supportive Care and Decontamination

• For suspected poisoning or drug overdose, activated charcoal should be administered at a dose of 1 g/kg body weight (50-100g for adults) as soon as possible, ideally within 1 hour of ingestion, as recommended by medical guidelines 2
• Activated charcoal is most effective when given within 1 hour of ingestion, but may be effective up to 4 hours for acetaminophen overdose and up to 6 hours for extended-release medications, based on the Hepatology guidelines 3
• The American Academy of Pediatrics recommends administering activated charcoal as an oral slurry or via nasogastric tube if the patient cannot take it orally, with commercially available preparations often containing sorbitol as a cathartic agent 4
• Non-sorbitol containing products should be used for children under 1 year and when repeated doses are necessary, as stated by the Pediatrics guidelines 4
• For acetaminophen overdose, activated charcoal should be given just prior to starting N-acetylcysteine (NAC), according to the Hepatology guidelines 3
• Activated charcoal is ineffective for poisoning with acids, bases, alcohols, organic solvents, inorganic salts, metals, iron, lithium, and potassium, and may pose a risk of aspiration if airway protective reflexes are impaired, as noted by the Pediatrics guidelines 4
• Consultation with a poison control center is recommended before administration, with a contact number of 800-222-1222 in the US, according to the Pediatrics guidelines 4
• Multiple doses may be indicated for drugs with extended-release formulations, medications with significant enterohepatic or entero-enteric circulation, and substances that persist longer in the stomach, although the exact protocol is not specified in the provided references 2, 3, 4