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 |