Isopropanol
·
Isopropyl alcohol, 2-propanol, Blue
heaven.*
·
Colourless, volatile liquid with a
faint odour of acetone and a slightly bitter taste.
·
Rubbing alcohol (70%), for massage.
·
Disinfectant.
·
Antifreeze.
·
Paint remover.
·
Window cleaning solution.
·
Toiletries (hair tonics, after-shave
lotions).
·
Industrial solvent.
·
About 250 to 300 ml.
·
In terms of blood level: > 300
mg%.
·
Isopropanol can be absorbed through
all routes. In the body it is rapidly metabolised by alcohol dehydrogenase.
Approximately 80% is converted to acetone and the remainder is excreted
unchanged in the urine. Acetone is excreted in the urine and breath, and also
metabolised to acetate, formate, and carbon dioxide.
·
Isopropanol is two to three times
more potent than ethanol as a CNS depressant.
·
Lethargy, vertigo, headache,
confusion, ataxia, dysarthria, nystagmus, miosis, abdominal pain, gastritis,
haemorrhagic tracheobronchitis, hypotension, and apnoea. Isopropanol is
generally believed to produce greater CNS depression than ethanol at comparable
blood levels. Deep coma and
·
areflexia are common following
severe intoxication. Ketonaemia and ketonuria may be present, generally without
metabolic acidosis.
·
Emesis and haemorrhagic gastritis
may occur following ingestion.
·
It can also cause haemolytic
anaemia, myopathy, and acute renal failure.
·
A characteristic odour of acetone is
usually perceptible in the breath.
·
Ketonuria.
·
Determine serum isopropanol
concentration and blood glucose. Blood isopropanol concentrations of 128 to 200
mg/100 ml, measured within hours after ingestion, have been associated with
deep coma and death.
·
The absence of hyperglycaemia or
glucosuria when acetone is present helps differentiate between alcohol
intoxication or diabetic ketoacidosis versus isopropanol intoxication
Isopropanol is metabolised to acetone. As acetone may contribute to CNS
depression, its blood level should also be routinely obtained and followed.
Acetone may be detectable in the urine by 3 hours after ingestion, and in the
blood by one-half to one hour after isopropanol inges- tion. A high serum or
urinary acetone without metabolic acidosis is strongly suggestive of
isopropanol intoxication.
·
Increased osmolal gap.
·
High anion gap metabolic acidosis.
·
Skin decontamination in the case of
dermal exposure. Stomach wash and activated charcoal in the case of inges-
tion. However, many investigators are of the opinion that activated charcoal
does not adsorb isopropanol efficiently.
·
Haemodialysis: Useful in patients
demonstrating marked symptoms (persistent hypotension, coma) unresponsive to
standard therapy.
·
Supportive measures, including
correction of hypotension, metabolic acidosis, etc.
·
Isopropanol may be generated
spontaneously in a dead body, presumably due to bacterial or other putrefaction
processes. This fact must be borne in mind when subjecting viscera to chemical
analysis.
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