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Ethanol 💊
ℹ️ About
- Always check the BNF 📖 or equivalent for prescribing and monitoring advice.
- Ethanol is sometimes used as an antidote in toxic alcohol poisoning (methanol or ethylene glycol) when fomepizole is unavailable.
⚙️ Mode of Action
- Ethanol has a higher affinity than methanol/ethylene glycol for the enzyme alcohol dehydrogenase (ADH) 🧪.
- It competitively inhibits metabolism of toxic alcohols to their toxic metabolites (e.g. formic acid, glycolic/oxalic acids), preventing organ damage (especially retinal, renal, and CNS).
💊 Indications & Dose
| Indication | Dose / Frequency | Route |
|---|---|---|
| Methanol / Ethylene glycol toxicity | Approx. 150 mL 40% ethanol (≈ vodka or spirits) titrated to maintain serum ethanol 100 mg/dL until methanol/ethylene glycol level < 20 mg/dL | PO / NG |
💡 IV ethanol formulations exist, but oral/NG administration is sometimes used in resource-limited settings.
⚠️ Interactions
- See BNF. May interact with CNS depressants, sedatives, and hypoglycaemics.
🔎 Cautions
- Requires frequent monitoring of ethanol blood levels and toxic alcohol levels.
- Titrate carefully to avoid severe intoxication.
- Consider alternative antidote (fomepizole) where available ✅.
🚫 Contraindications
- Absolute: cultural/religious reasons where ethanol use is unacceptable 🙏.
- Relative: history of seizures, severe liver disease, or concurrent CNS depressant use.
❗ Side Effects
- Ataxia, incoordination, CNS depression 🧠.
- Nausea, vomiting, hypoglycaemia (especially in children).
- Hepatotoxicity and dependence with repeated exposure.
📚 References
- BNF
- Goldfrank’s Toxicologic Emergencies - Alcohol Toxicity section
- UK Poisons Information Database (TOXBASE)
📝 Revisions
- Latest update: Added mechanism, clarified dose monitoring, and emphasised role of fomepizole as preferred antidote.
| The content on this website is provided for educational and informational purposes only to support exam preparation (e.g., MLA, MRCP, USMLE) and learning. This is NOT medical advice, diagnosis, treatment, or professional guidance. It does not replace consultation with a qualified healthcare professional, official guidelines (e.g., NICE, GMC, BNF), or supervised clinical practice. Always verify information with current, authoritative sources. Makindo and its contributors accept no liability for any reliance on this content, including errors, omissions, or any resulting harm, loss, or consequences. By using this site, you agree to these terms. |
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