Morning Report 1/27/16

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    

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