Overview
Introduction
A person who appears drunk but has no convincing ethanol explanation may be developing a toxic alcohol emergency.
NCLEX-RN
NCLEX-RN
A person who appears drunk but has no convincing ethanol explanation may be developing a toxic alcohol emergency. Ethylene glycol, found in many antifreeze products, initially causes mild intoxication; after alcohol dehydrogenase begins metabolizing it, glycolate drives severe metabolic acidosis and oxalate damages the kidneys while binding circulating calcium. The diagnostic pattern changes with time, so a normal osmolar gap or a low ethylene glycol concentration cannot reassure you in a late presentation. The immediate clinical objective is to block further metabolism with fomepizole while correcting life-threatening derangements and determining whether hemodialysis is needed.
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