4-Methylpyrazole and hemodialysis in ethylene glycol poisoning.
METHODS
Two patients severely intoxicated with ethylene glycol became anuric and were treated by hemodialysis and the antidote, 4-methylpyrazole. On admission, their plasma ethylene glycol concentrations were 0.42 and 3 g/L respectively and no alcohol was detected. The elimination of 4-methylpyrazole in the dialysate represented 45% of the total body elimination. Clearances of 4-methylpyrazole by hemodialysis were 80 mL/min and 52 mL/min respectively.


RESULTS
In such cases, the authors propose infusion of a 4-methylpyrazole loading dose of 10-20 mg/kg before dialysis and intravenous infusion of 1-1.5 mg/kg/h during the 8-12 hours of hemodialysis to compensate the loss in dialysate.
Jobard
E
E
Laboratoire de Pharmacologie et Toxicologie, Centre Hospitalier Universitaire, Angers, France.
Harry
P
P
Turcant
A
A
Roy
P M
PM
Allain
P
P
D000328:Adult; D000931:Antidotes / Q000627:therapeutic use*; D019855:Ethylene Glycol; D005026:Ethylene Glycols / Q000097:blood / Q000493:pharmacokinetics / Q000506:poisoning*; D000077604:Fomepizole; D006207:Half-Life; D006801:Humans; D008297:Male; D008875:Middle Aged; D011720:Pyrazoles / Q000097:blood / Q000493:pharmacokinetics / Q000627:therapeutic use*; D006435:Renal Dialysis / Q000379:methods*
D000931:Antidotes; D005026:Ethylene Glycols; D011720:Pyrazoles; D000077604:Fomepizole; D019855:Ethylene Glycol