4-Methylpyrazole and hemodialysis in ethylene glycol poisoning

J Toxicol Clin Toxicol. 1996;34(4):373-7. doi: 10.3109/15563659609013806.

Abstract

Case reports: Two patients severely intoxicated with ethylene glycol became anuric and were treated by hemodialysis and the antidote, 4-methylpyrazole. On admission, their plasma ethylene glycol concentrations were 0.42 and 3 g/L respectively and no alcohol was detected. The elimination of 4-methylpyrazole in the dialysate represented 45% of the total body elimination. Clearances of 4-methylpyrazole by hemodialysis were 80 mL/min and 52 mL/min respectively.

Results: In such cases, the authors propose infusion of a 4-methylpyrazole loading dose of 10-20 mg/kg before dialysis and intravenous infusion of 1-1.5 mg/kg/h during the 8-12 hours of hemodialysis to compensate the loss in dialysate.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antidotes / therapeutic use*
  • Ethylene Glycol
  • Ethylene Glycols / blood
  • Ethylene Glycols / pharmacokinetics
  • Ethylene Glycols / poisoning*
  • Fomepizole
  • Half-Life
  • Humans
  • Male
  • Middle Aged
  • Pyrazoles / blood
  • Pyrazoles / pharmacokinetics
  • Pyrazoles / therapeutic use*
  • Renal Dialysis / methods*

Substances

  • Antidotes
  • Ethylene Glycols
  • Pyrazoles
  • Fomepizole
  • Ethylene Glycol