Table 1.

Major alcohol intoxicationsa

DisorderSubstance(s) Causing ToxicityClinical and Laboratory AbnormalitiesComments
Alcoholic (ethanol) ketoacidosisβ-hydroxybutyric acidAcetoacetic acidMetabolic acidosisMay be most frequent alcohol-related disorder; mortality low relative to other alcohols; rapidly reversible with fluid administration; increase in SOsm inconsistent
Methanol intoxicationFormic acidLactic acidKetonesMetabolic acidosis, hyperosmolality, retinal damage with blindness, putaminal damage with neurologic dysfunctionLess frequent than ethylene glycol; hyperosmolality and high anion gap acidosis can be present alone or together; mortality can be high if not treated quickly
Ethylene glycol intoxicationGlycolic acidCalcium oxalateMyocardial and cerebral damage and renal failure; metabolic acidosis, hyperosmolality, hypocalcemiaMore frequent than methanol intoxication; important cause of intoxications in children; hyperosmolality and high anion gap acidosis can be present alone or together
Diethylene glycol intoxication2-Hydroxyethoxyacetic acidNeurological damage, renal failure, metabolic acidosis, hyperosmolalityVery high mortality possibly related to late recognition and treatment; most commonly results from ingestion in contaminated medications or commercial products; hyperosmolality may be less frequent than with other alcohols
Propylene glycol intoxicationLactic acidMetabolic acidosis, hyperosmolalityMay be most frequent alcohol intoxication in ICU; minimal clinical abnormalities; stopping its administration is sufficient treatment in many cases
Isopropanol intoxicationIsopropanolComa, hypotension, hyperosmolalityHyperosmolality without acidosis; positive nitroprusside reaction
  • a ICU, intensive care unit.