Great Discussion today! Thanks to Mike Cruz for presenting.
- Remember that isopropyl alcohol and ethanol causes an osmolar gap without an anion gap.
- Beware of a normal osmolar gap in a patient with a positive volatile screen – this could reflect complete conversion of the parent compound to toxic metabolites
| Name | Anion Gap | Osmolar Gap | Toxicity | Treatment |
| Methanol | ELEVATED | YES | Retinal Toxicity from Formic Acid | Fomepizole |
| Ethylene Glycol
(antifreeze) |
ELEVATED | YES | Renal Failure, Oxalate crystals | Fomepizole, Ethanol |
| Propylene Glycol
(IV Lorazepam) |
ELEVATED | YES | Lactic Acidosis
CNS depression |
HD if severe |
| Isopropyl Alcohol
(rubbing alcohol) |
NORMAL | YES | Sedation | Supportive Care |
| Ethanol | NORMAL | YES |
SCVMC IM Chief Resident Blog 