Ethylene glycol intoxication: case report and pharmacokinetic perspectives.
A 42-year-old man was brought to the emergency department with ethylene glycol intoxication. He was hemodynamically stable and had normal renal function. His serum ethylene glycol concentration was 284 mg/dl approximately 1 hour after ethylene glycol consumption. The patient was treated with fomepizole and forced diuresis. Elimination of ethylene glycol in this patient followed first-order pharmacokinetics. Elimination pharmacokinetics in this patient were compared with that in a patient who received fomepizole and hemodialysis. Fomepizole monotherapy can be given in patients without renal failure or metabolic acidosis even with serum ethylene glycol concentrations greater than 50 mg/dl. However, cost estimates based on this case suggest that if the patient is treated adequately with a single hemodialysis session and 24-hour hospitalization, then fomepizole monotherapy may be more expensive than the combination regimen of fomepizole and hemodialysis.
Vasavada
Nina
N
Division of Nephrology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA. nina_vasavada_panchal@hotmail.com
Williams
Craig
C
Hellman
Richard N
RN
D000328:Adult; D000931:Antidotes / Q000627:therapeutic use; D019855:Ethylene Glycol / Q000097:blood / Q000493:pharmacokinetics* / Q000506:poisoning*; D000077604:Fomepizole; D006801:Humans; D008297:Male; D011041:Poisoning / Q000188:drug therapy; D011720:Pyrazoles / Q000627:therapeutic use
D000931:Antidotes; D011720:Pyrazoles; D000077604:Fomepizole; D019855:Ethylene Glycol