• Isopropyl Alcohol
• Rubbing Alcohol
  
• Hand sanitizers

• None
• Isopropanol does not get metabolized to a toxic acid metabolite like ethylene glycol and methanol.

• Inebriation (Intoxication)
• GI (rarely, Hemorrhagic gastritis)

• Normal anion gap
• Elevated osmol gap
• Normal arterial pH
• False elevations in serum creatinine
• Isopropanol gets metabolized to acetone, which can interfere with colorimetric creatinine assay, especially those using the Jaffe alkaline picrate reaction.
• BUN & GFR remains normal

• Conversion Factor = 6.0
• How to estimate isopropanol concentration (while waiting for actual level):
• Calculate Osm = (2 x Na) + (BUN/2.8) + (Glucose/18) + (Ethanol level/4.6)
• Determine Osm Gap = (Measured Osm) - (Calculated Osm)
• If Gap > 15 = abnormal
• If Gap > 25 = very high à give empiric fomepizole (Antizol) if unsure of ingestion
• Estimate Isopropanol Concentration (mg/dL) = 6.0  x Osm gap

• General Notes:
• Call or consult with Poison Center 1-800-222-1222
• The half-life of the parent compound (isopropanol)
• No Treatment = 3 hrs
• GI Decontamination:
• Generally avoided
• Rarely helpful unless very early on (within 15-30 min) since alcohols are rapidly absorbed or co-ingestions and airway is protected
• Proton Pump Inhibitor Therapy:
  
• May theoretically help reduce the risk of hemorrhagic gastritis

• There is no antidote as isopropanol does not get metabolized to a toxic acid.
• Since isopropanol gets metabolized to acetone you might notice a fruity odor due to ketosis

• Toxicology:  Ethylene Glycol - Overview
• Toxicology:  Methanol - Overview
• Pharmacology:  Propylene Glycol Containing IV Medications
• Differential Diagnosis:  Anion Gap (Elevated)
• Differential Diagnosis:  Osmolar Gap (Elevated)
• Calculator:  Anion Gap
  

• South Med J 2009;102:867-69.
• Am J Med 2006;119:e9.
  
• Am J Kidney Dis 2002;40:e12.

Editors:  Anthony J. Busti, MD, PharmD, FNLA, FAHA

Last Reviewed:  July 2015