Propylene glycol-induced side effects during intravenous nitroglycerin therapy.
Propylene glycol, an alcohol frequently used as a solvent in medical preparations, is considered non-toxic. We found that this solvent, used in a commercially available IV nitroglycerin solution, may cause hyperosmolality, hemolysis and lactic acidosis. The influence of kidney function as the main determinant in causing accumulation of this solvent and consequently hyperosmolality is emphasized. A review of the literature dealing with propylene glycol is given. The possible mechanisms of neurological disturbances occurring during IV nitroglycerin therapy are discussed.
D000140:Acidosis, Lactic / Q000139:chemically induced*; D000328:Adult; D000368:Aged; D003327:Coronary Disease / Q000188:drug therapy; D005260:Female; D006461:Hemolysis / Q000187:drug effects; D006801:Humans; D007668:Kidney / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D005996:Nitroglycerin / Q000008:administration & dosage / Q000627:therapeutic use*; D009994:Osmolar Concentration; D019946:Propylene Glycol; D011409:Propylene Glycols / Q000009:adverse effects*; D012997:Solvents / Q000009:adverse effects*; D014883:Water-Electrolyte Imbalance / Q000139:chemically induced*
D011409:Propylene Glycols; D012997:Solvents; D019946:Propylene Glycol; D005996:Nitroglycerin