Toxic alcohol diagnosis and management: an emergency medicine review

Intern Emerg Med. 2018 Apr;13(3):375-383. doi: 10.1007/s11739-018-1799-9. Epub 2018 Feb 9.


Toxic alcohols are a group of substances containing a hydroxyl group not meant to be ingested. They are the cause of a significant number of accidental and non-accidental exposures. Toxic alcohol poisoning can be associated with a significant degree of morbidity and mortality if not promptly recognized and treated. This review describes the clinical presentation and an approach to the recognition and management for toxic alcohol poisoning. Toxic alcohols classically refer to a group of alcohols not meant for ingestion. Methanol, ethylene glycol, and isopropyl alcohol are readily available in common hardware and household materials. Toxic alcohols are ingested for a variety of reasons including accidental exposures, intentional inebriation, homicide and suicide. The patient with an altered mental status or concerning history warrants consideration of this potentially deadly ingestion. Treatment considerations include alcohol dehydrogenase blockade and hemodialysis. Toxic alcohol poisoning can be an elusive diagnosis. This review evaluates toxic alcohol poisoning signs and symptoms and an approach to diagnosis and management.

Keywords: Alcohol; Ethylene glycol; Fomepizole; Hemodialysis; Isopropyl alcohol; Methanol; Toxic alcohol.

Publication types

  • Review

MeSH terms

  • 2-Propanol / adverse effects
  • Alcohol Drinking / adverse effects*
  • Alcohol Drinking / physiopathology
  • Alcohol Drinking / psychology
  • Alcohols / adverse effects*
  • Alcohols / metabolism
  • Alcohols / pharmacokinetics
  • Antidotes / therapeutic use
  • Emergency Service, Hospital / organization & administration
  • Ethanol / therapeutic use
  • Ethylene Glycol / adverse effects
  • Fomepizole
  • Humans
  • Methanol / adverse effects
  • Pyrazoles / therapeutic use
  • Renal Dialysis / methods


  • Alcohols
  • Antidotes
  • Pyrazoles
  • Ethanol
  • Fomepizole
  • Ethylene Glycol
  • 2-Propanol
  • Methanol