Parenteral Manual

Alcohol

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Alternate Name(s): 
Alcohol dehydrated 100%, Ethyl alcohol, Ethanol, EtOH
Classification: 
Antidote, Ethylene Glycol Toxicity; Antidote, Methanol Toxicity.
Original Date: 
September 2012
Indications: 
  • Antidote for ethylene glycol (such as antifreeze) or methanol (such as windshield washer fluid) poisoning.
Reconstitution and Stability: 
  • Available as a 100% solution stored at room temperature
  • Clear solution
Compatibility: 

- Solution Compatible:  D5W, D10W , 0.9% Sodium Chloride, dextrose-saline

INCOMPATIBLE:  ringer's solution, ringer's lactate

Administration: 

(For approved routes of administration by nursing personnel, refer to Policy for the Administration of Intravenous Medications.)

SC NO
IM NO
IV Direct NO
IV Intermittent Infusion YES
Usual dilution:  10% (100 mg/mL)
> 10%  must be given via central line
Infusion time:  30 - 60 minutes
IV Continuous Infusion

YES
Usual dilution:  10% (100 mg/mL)
>10 % must be given via central line
Dosage: 

(For neonatal dosages, refer to Neonatal IV Drug Manual.)

***Dosage should be based according to ideal body weight***

- Load;  0.8 g/kg/dose (8 - 10 mL/kg of 10% ethanol solution), not to exceed 200 mL through a central line over 30 - 60 minutes 
- Follow by infusion  - 80 - 150 mg/kg/hr  - (66 mg/kg/hr- for a non drinker,110 mg/kg/hr for an average drinker, 154mg/kg/hr for a chronic drinker)
- Continue therapy until methanol or ethylene glycol blood level< 10 mg/dL
- Do not stop infusion abruptly;  taper over 24 - 48 hours or more.
- During hemodialysis either add ethanol to the dialysate to achieve a 100 mg/dL concentration OR increase the rate of infusion during dialysis (10% ethanol 2.5 - 3.5 mL/kg/hr) 

                               

Potential hazards of parenteral administration: 
  • Cardiovascular:  flushing, hypotension
  • Central Nervous System:  agitation, CNS depression, coma, disorientation, drowsiness, encephalopathy, headache, sedation, seizure, vertigo
  • Endocrine and metabolic:  hypoglycemia , especially in children, diabetics and malnourished patients
  • Gastrointestinal:  gastric irritation, nausea and vomiting
  • Genitourinary:  urinary retention
  • Local:  nerve and tissue destruction, phlebitis
  • Renal:  polyuria
  • Miscellaneous:  intoxication
Notes: 
  • Dehydrated alcohol 100% = 78.9 g/100 mL (or 78.9% w/v)
  • Monitor blood glucose and blood EtOH concentrations during therapy.  Continue therapy until methanol or ethylene glycol levels are undetectable

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