Does isopropyl alcohol (isopropanol) cause metabolic acidosis?

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From the Research

Yes, isopropyl alcohol can cause acidosis when ingested, as it is metabolized to acetone, leading to metabolic acidosis, a condition characterized by an excess of acid in the body. This occurs because the liver converts isopropyl alcohol to acetone through alcohol dehydrogenase, the same enzyme that metabolizes ethanol 1. Unlike ethanol, which is converted to acetic acid and can be used by the body, acetone accumulates and causes acidosis. Symptoms of isopropyl alcohol poisoning include confusion, low blood pressure, rapid heart rate, vomiting, abdominal pain, and in severe cases, coma or death.

Key Points to Consider

  • Isopropyl alcohol ingestion is a medical emergency requiring immediate attention, and even small amounts can be dangerous, especially in children 2.
  • Treatment typically involves supportive care, including intravenous fluids, correction of electrolyte imbalances, and in some cases, hemodialysis to remove the alcohol from the bloodstream 3.
  • The importance of an anion gap metabolic acidosis in relation to toxic alcohols, including isopropyl alcohol, should be recognized, as it is a critical aspect of patient management 1, 2.
  • The osmol gap can be useful in patient management but also has limitations that should be considered when diagnosing and treating isopropyl alcohol poisoning 1, 2.

Clinical Implications

  • Prompt recognition and treatment of isopropyl alcohol poisoning are crucial to prevent significant morbidity and mortality.
  • Clinicians should be aware of the potential for isopropyl alcohol to cause acidosis and take appropriate measures to diagnose and manage this condition effectively.
  • The use of fomepizole and ethanol as potent inhibitors of alcohol dehydrogenase can reduce the generation of toxic metabolites, and hemodialysis can be an effective way of detoxification 3.

References

Research

Toxic Alcohol Poisoning.

Emergency medicine clinics of North America, 2022

Research

Toxic Alcohols.

Critical care clinics, 2021

Research

Ethylene glycol, methanol and isopropyl alcohol intoxication.

The American journal of the medical sciences, 2010

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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