American Academy of Clinical Toxicology Practice Guidelines on the Treatment of Ethylene Glycol Poisoning

REFERENCES

• Anonymous. Possible death from drinking ethylene glycol (“Prestone”). JAMA 1930; 94: 1940
   Google Scholar
• McDonald S F. Poisoning from drinking glycol ethylene. Med J Austr 1947; 1: 204–205
   PubMedGoogle Scholar
• Pons C A, Custer R P. Acute ethylene glycol poisoning: A clinico-pathologic report of eighteen fatal cases. Am J Med Sci 1946; 211: 544–552
   PubMed Web of Science ®Google Scholar
• Goldsher M, Better O S. Antifreeze poisoning during the October 1973 War in the Middle-East: Case reports. Military Med 1979; 144: 314–315
   PubMed Web of Science ®Google Scholar
• Moriarty R W, McDonald R H, Jr. The spectrum of ethylene glycol poisoning. Clin Toxicol 1974; 7: 583–596
   PubMed Web of Science ®Google Scholar
• Haggerty R J. Toxic hazards deaths from permanent antifreeze ingestion. N Engl J Med 1959; 261: 1296–1297
   PubMed Web of Science ®Google Scholar
• Walton E W. An epidemic of antifreeze poisoning. Med Sci Law 1978; 18: 321–327
   Google Scholar
• Karlson-Siber C, Persson H. Ethylene glycol poisoning: Experiences from an epidemic in Sweden. J Toxicol Clin Toxicol 1992; 30: 565–574
   PubMedGoogle Scholar
• Litovitz T L, Klein-Schwartz W, Dyer K S, Shannon M, Lee S, Powers M. 1997 Annual report of the American Association of Poison Control Centers Toxic Exposure Surveillance System. Am J Emerg Med 1998; 16: 443–497
   PubMed Web of Science ®Google Scholar
• Barton T L, Oehme F W. The incidence and characteristics of animal poisonings seen at Kansas State University from 1975–1980. Vet Hum Toxicol 1981; 23: 101–102
   PubMedGoogle Scholar
• Amstrup S C, Oehme F W, Myers K C, Gardner C. Ethylene glycol (antifreeze) poisoning in a free-ranging polar bear. Vet Hum Toxicol 1989; 31: 317–319
   PubMedGoogle Scholar
• Page I H. Ethylene glycol. Pharmacological study. J Pharmacol Exp Ther 1927; 330: 313–320
   Google Scholar
• Hanzlik P J, Seidenfeld M A, Johnson C C. General properties, irritant and toxic actions of ethylene glycol. J Pharmacol 1931; 41: 387
   Google Scholar
• Bachem C. Pharmakologische untersuchungen uber glykol and seine verwendung in der pharmazie and medizin. Med Klin 1917; 1: 7
   Google Scholar
• Widman C. A few cases of ethylene glycol intoxication. Acta Med Scand 1946; 126: 294–306
   Google Scholar
• Hunt R. Toxicity of ethylene and propylene glycol. Ind Eng Chem 1932; 24: 361
   Google Scholar
• Hunt R. Toxicity of ethylene and propylene glycols. Ind Eng Chem 1932; 24: 836–837
   Google Scholar
• Hanzlick P J, Seidenfeld M A, Johnson C C. General properties, irritant and toxic actions of ethylene glycol. J Pharm 1931; 41: 387–406
   Google Scholar
• Mundy R L, Hall L M, Teague R S. Pyrazole as an antidote for ethylene glycol poisoning. Toxicol Appl Pharmacol 1974; 28: 320–322
   PubMed Web of Science ®Google Scholar
• Gessner P K, Parke D V, Williams R T. Studies in detoxication. 86. The metabolism of 14C-labelled ethylene glycol. Biochem J 1961; 79: 482–489
   PubMed Web of Science ®Google Scholar
• Dail S M, Thrall M AH, Hamar D W. Comparison of ethanol and 4-methylpyrazole as treatments for ethylene glycol intoxication in cats. Am J Vet Res 1994; 55: 1771–1792
   PubMed Web of Science ®Google Scholar
• Scully R, Galdabini J, McNealy B. Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 38-1979. N Engl J Med 1979; 301: 650–657
   PubMedGoogle Scholar
• Stokes J B, Averon F. Prevention of organ damage in massive ethylene glycol ingestion. JAMA 1980; 243: 2065–2066
   PubMed Web of Science ®Google Scholar
• Johnson B, Meggs W J, Bentzel C J. Emergency department hemodialysis in a case of severe ethylene glycol poisoning. Ann Emerg Med 1999; 33: 108–110
   PubMed Web of Science ®Google Scholar
• Driver J, Tardiff R G, Sedik L, Wester R C, Maibach H I. In vitro percutaneous absorption of [14C] ethylene glycol. J Exposure Anal Environ Epidemiol 1993; 3: 277–284
   PubMedGoogle Scholar
• Wills J H, Coluston F, Harris E S, McChesney E W, Russell J C, Serrone D M. Inhalation of aerosolized ethylene glycol by man. Clin Toxicol 1974; 7: 463–476
   PubMed Web of Science ®Google Scholar
• Jacobsen D, McMartin K E. Antidotes for methanol and ethylene glycol poisoning. J Toxicol Clin Toxicol 1997; 35: 127–143
   PubMed Web of Science ®Google Scholar
• Cheng J-T, Beysolow T D, Kaul B, Weisman R, Feinfeld D A. Clearance of ethylene glycol by kidneys andhemodialysis. J Toxicol Clin Toxicol 1987; 25: 94–108
   Google Scholar
• McChesney E W, Goldberg L, Harris E S. Reappraisal of the toxicology of ethylene glycol. IV. The metabolism of labeled glycolic and glyoxylic acids in the rehsus monkey. Food Cosmet Toxicol 1972; 10: 655–670
   PubMedGoogle Scholar
• Peterson D C, Collins A J, Himes J M, Bullock M L, Keane W F. Ethylene glycol poisoning. Pharmacokinetics during therapy with ethanol and hemodialysis. N Engl J Med 1981; 304: 21–23
   PubMed Web of Science ®Google Scholar
• Eder A F, McGrath C M, Dowdy Y G, et al. Ethylene glycol poisoning. Toxicokinetic and analytical factors affecting laboratory diagnosis. Clin Chem 1998; 44: 168–177
   PubMed Web of Science ®Google Scholar
• Vestal R E, McGuire E A, Tobin J D, Andres R, Norris A H, Mezey E. Aging and ethanol metabolism. Clin Pharmacol Ther 1977; 21: 343–354
   PubMed Web of Science ®Google Scholar
• Weiss B, Coen G. Effect of ethanol on ethylene glycol oxidation by mammalian liver enzymes. Enzymes Biol Clin 1966; 6: 297–304
   PubMedGoogle Scholar
• Brent J, McMartin K, Phillips S, et al. Fomepizole for the treatment of ethylene glycol poisoning. N Engl J Med 1999; 340: 832–838
   PubMed Web of Science ®Google Scholar
• McChesney E W, Goldberg L, Parekh C K, Russell J C. Reappraisal of the toxicology of ethylene glycol. II. Metabolism studies in laboratory animals. Food Cosmet Toxicol 1971; 9: 21–38
   PubMedGoogle Scholar
• Clay K L, Murphy R C. On the metabolic acidosis of ethylene glycol intoxication. Toxicol Appl Pharmacol 1977; 39: 39–49
   PubMed Web of Science ®Google Scholar
• Mair W. Cerebral computed tomography of ethylene glycol intoxication. Neuroradiol 1983; 24: 175–177
   PubMed Web of Science ®Google Scholar
• Berman L B, Schreiner G E, Feys J. The nephrotoxic lesion of ethylene glycol. Ann Intern Med 1957; 46: 611–619
   PubMed Web of Science ®Google Scholar
• Walker J T, Keller M S, Katz S M. Computed tomographic and sonographic findings in acute ethylene glycol poisoning. J Ultrasound Med 1983; 2: 429–431
   PubMed Web of Science ®Google Scholar
• Bove K E. Ethylene glycol toxicity. Am J Clin Pathol 1966; 45: 46–50
   PubMed Web of Science ®Google Scholar
• Introna F, Jr, Smialek J E. Antifreeze (ethylene glycol) intoxications in Baltimore. Report of six cases. Acta Morpologica Hungarica 1989; 37: 245–263
   PubMedGoogle Scholar
• Milles G. Ethylene glycol poisoning with suggestions for its treatment as oxalate poisoning. Arch Pathol 1946; 41: 631–638
   Google Scholar
• Gabow P A, Clay K, Sullivan J B, Lepoff R. Organic acids in ethylene glycol intoxication. Ann Intern Med 1986; 105: 16–20
   PubMed Web of Science ®Google Scholar
• Garibotto G, Paoletti E, Acquarone N. Glyoxylic acid in ethylene glycol poisoning. Nephron 1988; 48: 248–249
   PubMedGoogle Scholar
• Moreau C L, Kearns W, II, Tomaszewski C A, McMartin K E, Rose S R, Ford M D, Brent J. Glycolate kinetics and hemodialysis clearance in ethylene glycol poisoning. J Toxicol Clin Toxicol 1998; 36: 659–666
   PubMed Web of Science ®Google Scholar
• Jacobsen D, Ovrebo S, Ostborg J, Sejerstd O M. Glycolate causes the acidosis in ethylene glycol poisoning and is effectively removed by hemodialysis. Acta Med Scand 1984; 216: 409–416
   PubMed Web of Science ®Google Scholar
• Aquino H C, Leonard C D. Ethylene glycol poisoning: Report of three cases. J Ky Med Assoc 1972; 70: 463–465
   PubMedGoogle Scholar
• Smith D E. Morphologic lesions due to acute and subacute poisoning with antifreeze (ethylene glycol). AMA Arch Pathol 1951; 51: 423–433
   PubMedGoogle Scholar
• Berman L B, Schreiner G I, Feys J. The nephrotoxic lesion of ethylene glycol. Ann Intern Med 1957; 46: 611–619
   PubMed Web of Science ®Google Scholar
• Levy R I. Renal failure secondary to ethylene glycol intoxication. JAMA 1960; 173: 1210–1213
   PubMed Web of Science ®Google Scholar
• Munro K MH, Adams J H. Acute ethylene glycol poisoning: Report of a fatal case. Med Sci Law 1967; 7: 181–184
   PubMed Web of Science ®Google Scholar
• Kahn H S, Brotchner R J. A recovery from ethylene glycol (antifreeze) intoxication; A case of survival and two fatalities from ethylene glycol including autopsy findings. Ann Intern Med 1950; 32: 284–294
   PubMed Web of Science ®Google Scholar
• Linnanvuo-Laitinen M, Huttunen K. Ethylene glycol intoxication. J Toxicol Clin Toxicol 1986; 24: 167–174
   PubMed Web of Science ®Google Scholar
• Brown C G, Trumbull D, Klein-Schwartz W, Walker J D. Ethylene glycol poisoning. Ann Emerg Med 1983; 12: 501–506
   PubMed Web of Science ®Google Scholar
• Hylander B, Kjellstand C M. Prognostic factors and treatment of severe ethylene glycol intoxication. Intensive Care Med 1996; 22: 546–552
   PubMed Web of Science ®Google Scholar
• Steinke W, Arendt G, Mull M, Reiners K, Toyka K V. Good recovery after sublethal ethylene glycol intoxication: Serial EEG and CT findings. J Neurol 1989; 236: 170–173
   PubMed Web of Science ®Google Scholar
• Collins J M, Hennes D M, Holzgang C R, Gourley R T, Porter G A. Recovery after prolonged oliguria due to ethylene glycol intoxication. The prognostic value of serial, percutaneous renal biopsy. Arch Intern Med 1970; 125: 1059–1062
   PubMed Web of Science ®Google Scholar
• Berger J R, Ayyar R A. Neurological complication of ethylene glycol intoxication. Report of a case. Arch Neurol 1981; 38: 724–726
   PubMed Web of Science ®Google Scholar
• Spillane L, Roberts J R, Meyer A E. Multiple cranial nerve deficits after ethylene glycol poisoning. Ann Emerg Med 1991; 20: 208–210
   PubMed Web of Science ®Google Scholar
• Fellman D M. Facial diplegia following ethylene glycol. Arch Neurol 1982; 39: 739–740
   PubMed Web of Science ®Google Scholar
• Factor S A, Lava N S. Ethylene glycol intoxication: A new stage in the clinical syndrome. N Y State J Med 1987; 87: 179–180
   PubMedGoogle Scholar
• Lewis L D, Smith B W, Mamourian A C. Delayed sequelae after acute overdoses or poisonings: Cranial neuropathy related to ethylene glycol ingestion. Clin Pharmacol Ther 1997; 61: 692–699
   PubMed Web of Science ®Google Scholar
• Catchings T T, Beamer W C, Lundy L, Prough DS. ARDS secondary to ethylene glycol ingestion. Ann Emerg Med 1985; 14: 594–596
   PubMed Web of Science ®Google Scholar
• Gordon H L, Hunter J M. Ethylene glycol poisoning. Anaesthesia 1982; 37: 332–338
   PubMed Web of Science ®Google Scholar
• Bobbit W H, Williams R M, Freed C R. Severe ethylene glycol intoxication with multisystemic failure. West J Med 1986; 144: 225–228
   PubMedGoogle Scholar
• Sulway M J, Malins J M. Acetone in diabetic ketoacidosis. Lancet 1970; ii: 736–740
   Google Scholar
• Sklar A H, Linas S L. The osmolal gap in renal failure. Ann Intern Med 1983; 98: 481–482
   PubMed Web of Science ®Google Scholar
• Schelling J R, Howard R L, Winter S D, Linas L S. Increased osmolal gap in alcoholic ketoacidosis and lactic acidosis. Ann Intern Med 1990; 113: 580–582
   PubMed Web of Science ®Google Scholar
• Bekeris L, Baker C, Fenton J, Kimball D, Bermes E. propylene glycol as a cause of elevated serum osmolality. Am J Clin Pathol 1979; 72: 633–636
   PubMed Web of Science ®Google Scholar
• Eisen T F, Lacouture P G, Woolf A. Serum osmolality in alcohol ingestions: Differences in availability among laboratories of teaching hospital, non-teaching hospital, and commercial facilities. Am J Emerg Med 1989; 7: 256–259
   PubMed Web of Science ®Google Scholar
• Aabakken L, Johansen K S, Rydningen E-B, Bresden J E, Ovrebo S, Jacobsen D. Osmolal and anion gaps in patients admitted to an emergency medical department. Human Exp Toxicol 1994; 13: 131–134
   PubMed Web of Science ®Google Scholar
• Hewlett T P, McMartin K E, Lauro A J, Ragan F A. Ethylene glycol poisoning: The value of glycolic acid determinations for diagnosis and treatment. J Toxicol Clin Toxicol 1986; 24: 389–402
   PubMed Web of Science ®Google Scholar
• Huhn K M, Rosenberg F M. Critical clue to ethylene glycol poisoning. Can Med Assoc J 1995; 152: 193–195
   Web of Science ®Google Scholar
• Hoffman R S, Smilkstein M J, Howland M A, Goldfrank L R. Osmal gaps revisited: Normal values and limitations. J Toxicol Clin Toxicol 1993; 31: 81–93
   PubMed Web of Science ®Google Scholar
• Glasser L, Sternglanz P D, Combie J, Robinson. A Serum osmolality and its applicability to drug overdose. Am J Clin Pathol 1973; 60: 695–699
   PubMed Web of Science ®Google Scholar
• Heckerling P S. Ethylene glycol poisoning with a normal anion gap due to occult bromide intoxication. Ann Emerg Med 1987; 16: 1384–1386
   PubMed Web of Science ®Google Scholar
• Leon M, Graeber C. Absence of high anion gap metabolic acidosis in severe ethylene glycol poisoning: A potential effect of simultaneous lithium carbonate ingestion. Am J Kidney Dis 1994; 23: 313–316
   PubMed Web of Science ®Google Scholar
• Foit F F, Jr, Cowell R L, Brobst D F, Moore M P, Tarr B D. X-ray powder diffraction and microscopic analysis of crystalluria in dogs with ethylene glycol poisoning. Am J Vet Res 1985; 46: 2404–2408
   PubMed Web of Science ®Google Scholar
• Jacobsen D, Hewlett T P, Webb R, Brown S T. Ethylene glycol intoxication: Evaluation of kinetics and crystalluria. Am J Med 1988; 84: 145–152
   PubMed Web of Science ®Google Scholar
• Grauer G F, Thrall M A, Henre B A, Grauer R M, Hamar D W. Early clinicopathologic findings in dogs ingesting ethylene glycol. Am J Vet Res 1987; 45: 2299–2303
   Google Scholar
• Saladino R, Shannon M. Accidental and intentional poisonings with ethylene glycol in infancy: Diagnostic clues and management. J Ped Emerg Care 1991; 7: 93–96
   PubMedGoogle Scholar
• Friedman E A, Greenberg J B, Merill J P, Damin G J. Consequences of ethylene glycol poisoning. Report of four cases and review of the literature. Am J Med 1962; 32: 891–902
   PubMed Web of Science ®Google Scholar
• Parry M F, Wallach R. Ethylene glycol poisoning. Am J Med 1974; 57: 143–150
   PubMed Web of Science ®Google Scholar
• Flanagan P, Libcke J H. Renal biopsy observations following recovery from ethylene glycol nephrosis. Am J Clin Pathol 1964; 41: 171–175
   PubMed Web of Science ®Google Scholar
• Jacobsen D, Akesson I, Shefter E. Urinary calcium oxalate monohydrate crystals in ethylene glycol poisoning. Scand J Clin Lab Invest 1982; 42: 231–234
   PubMed Web of Science ®Google Scholar
• Turk J, Morrell L, Avioli L V. Ethylene glycol intoxication. Arch Intern Med 1986; 146: 1601–1603
   PubMed Web of Science ®Google Scholar
• Terlinsky A S, Grochowski J, Geoly K L, Stauch B S, Hefter L. Identification of atypical calcium oxalate crystalluria following ethylene glycol ingestion. Am J Clin Pathol 1981; 76: 223–226
   PubMed Web of Science ®Google Scholar
• Burns J R, Finalyson B. Changes in calcium oxalate crystal morphology as a function of concentration. Invest Urol 1980; 18: 174–177
   PubMedGoogle Scholar
• Winter M L, Ellis M D, Snodgrass W R. Urine fluorescence using a Wood’s lamp to detect the antifreeze additive sodium fluorescein: A qualitative adjunctive test in suspected ethylene glycol ingestions. Ann Emerg Med 1990; 19: 663–667
   PubMed Web of Science ®Google Scholar
• Tadokoro M, Onzono Y, Hara K, et al. A case of acute renal failure due to ethylene glycol intoxication. Jpn J Nephrol 1995; 37: 353–356
   Google Scholar
• Maier W. Cerebral computed tomography of ethylene glycol intoxication. Neuroradiology 1983; 24: 175–177
   PubMed Web of Science ®Google Scholar
• Sabeel A I, Kurkus J, Lindholm T. Intensified dialysis treatment of ethylene glycol intoxication. Scand J Urol Nephrol 1995; 29: 125–129
   PubMed Web of Science ®Google Scholar
• Underwood F, Bennett W M. Ethylene glycol intoxication. JAMA 1973; 226: 1453–1454
   PubMed Web of Science ®Google Scholar
• Curtin L, Kraner J, Wine H, Savitt D, Abuelo G. Complete recovery after massive ethylene glycol ingestion. Arch Intern Med 1992; 152: 1311–1313
   PubMed Web of Science ®Google Scholar
• Godolphin W, Meagher E P, Sanders H D, Frohlich J. Unusual calcium oxalate crystals in ethylene glycol poisoning. Clin Toxicol 1980; 16: 479–486
   PubMed Web of Science ®Google Scholar
• Porter W H, Auansakui A. Gas-chromatographic determination of ethylene glycol in serum. Clin Chem 1982; 28: 75–78
   PubMed Web of Science ®Google Scholar
• Bjellerup P, Kallner A, Kollind M. GLC determination of serum-ethylene glycol interferences in ketotic patients. J Toxicol Clin Toxicol 1994; 32: 85–87
   PubMed Web of Science ®Google Scholar
• Standefer J, Blackwell W. Enzymatic method for measuring ethylene glycol with a centrifugal analyzer. Clin Chem 1991; 37: 1734–1736
   PubMed Web of Science ®Google Scholar
• McMartin K E, Collins T D, Hewlett T P. High pressure liquid chromatographic assay of 4-methylpyrazole. Measurements of plasma and urine levels. J Toxicol Clin Toxicol 1984; 22: 133–148
   PubMed Web of Science ®Google Scholar
• Diczfalus U, Eklof R. Determination of 4-methylpyrazole in plasma using solid phase extraction and HPLC. Biomed Chromatogr 1987; 2: 226–227
   PubMedGoogle Scholar
• Jobard E, Turcant A, Harry P, Le Bouil A, Allain P. High-performance liquid chromatographic determination of 4-methylpyrazole in plasma and in dialysate. J Chromatogr 1997; 695: 444–447
   Web of Science ®Google Scholar
• Achari R, Mayersohn M. Analysis of 4-methylpyrazole in plasma and urine by gas chromatography with nitrogen-selective detection. J Pharm Sci 1984; 73: 690–693
   PubMed Web of Science ®Google Scholar
• Bjorkhem I, Blomstrand R, Lantto O, Svensson L. Determination of 4-methylpyrazol in serum with mass fragmentography. Biochem Med 1975; 12: 205–212
   PubMed Web of Science ®Google Scholar
• Nine J S, Moraca M, Virji M A, Rao K N. Serum-ethanol determination: Comparison of lactate and lactate dehydrogenase interference in three enzymatic assays. J Anal Toxicol 1995; 19: 192–196
   PubMed Web of Science ®Google Scholar
• Rainey P M. Relation between serum and whole-blood ethanol concentrations. Clin Chem 1993; 39: 2288–2292
   PubMed Web of Science ®Google Scholar
• American Academy of Clinical Toxicology and European Association of Poisons Centres and Clinical Toxicologists. Position statement: Gastric lavage. J Toxicol Clin Toxicol 1997; 35: 711–719
   PubMed Web of Science ®Google Scholar
• Neuvonen P J, Olkkola K T. Oral activated charcoal in the treatment of intoxications. Role of single and repeated doses. Med Toxicol 1988; 3: 33–58
   Google Scholar
• American Academy of Clinical Toxicology and European Association of Poisons Centres and Clinical Toxicologists. Position statement: Single-dose activated charcoal. J Toxicol Clin Toxicol 1997; 35: 721–741
   PubMed Web of Science ®Google Scholar
• Wacker W EC, Haynes H, Druyan R, Fisher W, Coleman J E. Treatment of ethylene glycol poisoning with ethyl alcohol. JAMA 1965; 194: 173–175
   Web of Science ®Google Scholar
• Roe O. Methanol poisoning: Its clinical course, pathogenesis and treatment. Acta Med Scand 1946; 126: 1–253
   Google Scholar
• Cowan J M, Jr, Weathermon A, McCutcheon, Jr, Oliver R D. Determination of volume of distribution for ethanol in male and female subjects. J Anal Toxicol 1996; 20: 287–290
   PubMed Web of Science ®Google Scholar
• Blume S B. Women and alcohol. A review. JAMA 1986; 256: 1467–1470
   PubMed Web of Science ®Google Scholar
• Holford N H. Clinical pharmacokinetics of ethanol. Clin Pharmacokinet 1987; 13: 273–292
   PubMed Web of Science ®Google Scholar
• Rangno R E, Kreeft J H, Sitar D S. Ethanol “dose-dependent” elimination: Michaelis-Menten v classical kinetic analysis. Br J Clin Pharmacol 1981; 12: 667–673
   PubMed Web of Science ®Google Scholar
• Pohorecky L A, Brick J. Pharmacology of ethanol. Pharmacol Ther 1988; 36: 335–427
   PubMed Web of Science ®Google Scholar
• Weiss B, Coen G. Effect of ethanol on ethylene glycol oxidation by mammalian liver enzymes. Enzymol Biol Clin 1966; 6: 297–304
   PubMedGoogle Scholar
• Davis D P, Bramwell K J, Hamilton R S, Williams S R. Ethylene glycol poisoning: Case report of a record-high level and a review. J Emerg Med 1997; 15: 653–667
   PubMedGoogle Scholar
• Haymond M W. Hypoglycemia in infants and children. Endocrinol Metab Clin North Am 1989; 18: 211–252
   PubMed Web of Science ®Google Scholar
• Derr R F. Simulation studies on ethanol metabolism in different human populations with a physiological pharmacokinetic model. J Pharm Sci 1993; 82: 677–682
   PubMed Web of Science ®Google Scholar
• Dipadova C, Worner T M, Julkunen R JK, Lieber C S. Effects of fasting and chronic alcohol consumption on the first-pass metabolism of ethanol. Gastroenterol 1987; 92: 1169–1173
   PubMed Web of Science ®Google Scholar
• Ammon E, Schafer C, Hofmann U, Klotz U. Disposition and first-pass metabolism of ethanol in humans: Is it gastric or hepatic and does it depend on gender?. Clin Pharmacol Ther 1996; 59: 503–513
   PubMed Web of Science ®Google Scholar
• McCoy H G, Cipolle R J, Ehlers S M, Sawchuk R J, Zaske D E. Severe methanol poisoning. Application of a pharmacokinetic model for ethanol therapy and hemodialysis. Am J Med 1979; 69: 804–807
   Google Scholar
• Salaspuro M P, Lindros K O, Pikkarainen P H. Effect of 4-methylpyrazole on ethanol elimination rate and hepatic redox changes in alcoholics with adequate or inadequate nutrition and in non-alcoholic controls. Metab Clin Exp 1978; 27: 631–639
   PubMed Web of Science ®Google Scholar
• Levy M L, Aranda M, Zelman V, Giannotta S L. Propylene glycol toxicity following continuous etomidate infusion for the control of refractory cerebral edema. Neurosurgery 1995; 37: 363–371
   PubMed Web of Science ®Google Scholar
• Lindros K O, Stowell A, Pikkarainen P, Salaspuro M. The disulfiram (Antabuse)-alcohol reaction in male alcoholics: Its efficient management by 4-methylpyrazole. Alcohol Clin Exp Res 1981; 5: 528–530
   PubMed Web of Science ®Google Scholar
• Inque K, Kera Y, Kiriyama T, Komura S. Suppression of acetaldehyde accumulation by 4-methylpyrazole in alcohol-hypersensitive Japanese. Jpn J Pharmacol 1985; 38: 43–48
   PubMedGoogle Scholar
• Faessel H, Houze P, Baud F J, Scherrmann J M. 4-Methylpyrazole monitoring during hemodialysis of ethylene glycol intoxicated patients. Eur J Clin Pharmacol 1995; 49: 211–213
   PubMed Web of Science ®Google Scholar
• Vu B D, Crouzier C, Hubert I, Galliot M, Baud F J, Bourdon R. Analytical and pharmacokinetic study of 4-methylpyrazole, a new antidote for the treatment of ethylene glycol intoxication. Ann Fais Exp Chim 1992; 85: 99–110
   Google Scholar
• Harry P, Turcant A, Bouachour G, Houze P, Alquier P, Allain P. Efficacy of 4-methylpyrazole in ethylene glycol poisoning: Clinical and toxicokinetic aspects. Hum Exp Toxicol 1994; 13: 61–64
   PubMed Web of Science ®Google Scholar
• Jacobsen D, Barron SK, Sebastian C S, Blomstrand R, McMartin K E. Non-linear kinetics of 4-methylpyrazole in healthy human subjects. Eur J Clin Pharmacol 1989; 37: 599–604
   PubMed Web of Science ®Google Scholar
• Blomstrand R, Ohman G. Studies on the metabolism of LADH-inhibitor 4-methylpyrazole in the rat. Life Sci 1973; 13: 107–112
   PubMed Web of Science ®Google Scholar
• Wu D F, Clejan L, Potter B, Cederbaum A I. Rapid decrease of cytochrome P-450IIE1 in primary hepatocyte culture and its maintenance by added 4-methylpyrazole. Hepatol 1990; 12: 1379–1389
   PubMed Web of Science ®Google Scholar
• Baud F J, Bismuth C, Garnier R, Galliot M, Astier A, Maistre G, Soffer M. 4-Methylpyrazole may be an alternative to ethanol therapy for ethylene glycol intoxication in man. J Toxicol Clin Toxicol 1986-7; 24: 463–483
   PubMed Web of Science ®Google Scholar
• Makar A B, Tephly T R. Inhibition of monkey liver alcohol dehydrogenase by 4-methylpyrazole. Biomed Med 1975; 13: 334–342
   Google Scholar
• Li T K, Theorell H. Human liver alcohol dehydrogenase: Inhibition by pyrazole and pyrazole analogs. Acta Chem Scand 1969; 23: 892–902
   PubMedGoogle Scholar
• Feierman D E, Cederbaum A I. Increased content of cytochrome p-450 and 4-methylpyrazole binding spectrum after 4-methylpyrazole treatment. Biochem Biophys Res Comm 1985; 126: 1076–1081
   PubMed Web of Science ®Google Scholar
• Chow H H, Hutchaleelaha A, Mayersohn M. Inhibitory effect of 4-methylpyrazole on antipyrine clearance in rats. Life Sci 1992; 50: 661–666
   PubMed Web of Science ®Google Scholar
• McMartin K E, Hedstrom K-G, Tolf B-R, Ostling-Wintzell H, Blomstrand R. Studies on the metabolic interactions between 4-methylpyrazole and methanol using the monkey as an animal model. Arch Biochem Biophys 1980; 199: 606–614
   PubMed Web of Science ®Google Scholar
• Grauer G F, Thrall M A Hull, Henre B, Hjelle J J. Comparison of the effects of ethanol and 4MP on the pharmacokinetics and toxicity of ethylene glycol in the dog. Toxicol Letters 1987; 35: 307–314
   PubMed Web of Science ®Google Scholar
• Antizol (fomepizole) formulary booklet. Orphan Medical, Inc, Minnetonka, Minnesota 1997
   Google Scholar
• Jobard E, Harry P, Turcant A, Roy P M, Allain P. 4-Methylpyrazole and hemodialysis in ethylene glycol poisoning. J Toxicol Clin Toxicol 1996; 34: 373–377
   PubMed Web of Science ®Google Scholar
• Jacobsen D, Sebastian C S, Dies D F, et al. Kinetic interaction between 4-MP and ethanol in healthy humans. Alcohol Clin Exp Res 1996; 20: 804–809
   PubMed Web of Science ®Google Scholar
• Jacobsen D, Sebastian C S, Blomstrand R, McMartin K E. 4-Methlprazole: A controlled study of safety in healthy human subjects after single, ascending doses. Metab Clin Exp Res 1988; 12: 516–522
   PubMed Web of Science ®Google Scholar
• Jacobsen D, Sebastian C S, Barron S K, Carriere E W, McMartin K E. Effects of 4-methylpyrazole, methanol/ethylene glycol antidote, in healthy humans. J Emerg Med 1990; 8: 455–461
   PubMedGoogle Scholar
• Blomstrand R, Ellin A, Lof A, Ostling-Wintzell H. Biological effects and metabolic interactions after chronic and acute administration of 4-methylpyrazole and ethanol to rats. Arch Biochem Biophys 1980; 199: 591–605
   PubMed Web of Science ®Google Scholar
• Kager L, Ericsson J L. Long-term toxicity study with alcohol and 4-methylpyrazole in rat. Acta Pathol Microbiol Scand 1974; 82(sect A): 534–538
   Google Scholar
• Sangster B, Prenen J A, DeGroot G. Ethylene glycol poisoning. N Engl J Med 1980; 302: 465
   PubMedGoogle Scholar
• Jacobsen D, Ostby N, Bredesen J E. Studies on ethylene glycol poisoning. Acta Med Scand 1982; 212: 11–15
   PubMed Web of Science ®Google Scholar
• Rothman A, Normann S A, Manoguerra A S, Bastian J F, Griswold W R. Short-term hemodialysis in childhood ethylene glycol poisoning. J Pediatr 1986; 108: 153–155
   PubMed Web of Science ®Google Scholar
• Hantson P, Hassoun A, Mahieu P. Ethylene glycol poisoning treated by IV 4-methylpyrazole. Intensive Care Med 1998; 24: 736–739
   PubMed Web of Science ®Google Scholar
• Da Roza R, Henning R J, Sunshine I, Sutheimer C. Acute ethylene glycol poisoning. Crit Care Med 1984; 12: 1003–1005
   PubMed Web of Science ®Google Scholar
• Chow M T, Chen J, Patel J S, Ali S, Noghnogh AA, Leehey D J, Ing T S. Use of a phosphorus-enriched dialysate to hemodialyze patients with ethylene glycol intoxication. Int J Artif Organs 1997; 20: 101–104
   PubMed Web of Science ®Google Scholar
• Clayton G D, Clayton F E. Patty's Industrial Hygiene and Toxicology. 3rd ed., John Wiley & Sons, New York 1982; 3817–3832
   Google Scholar