Toxicology and Overdose Management — Part 4: Toxic Alcohols, Metals, Organophosphates, Environmental & Chemical Poisonings

Complete management of methanol and ethylene glycol poisoning (fomepizole, hemodialysis), carbon monoxide, cyanide, organophosphates and nerve agents, iron poisoning, caustic ingestions, local anesthetic systemic toxicity (LAST), sympathomimetic toxicity, and enhanced elimination techniques including urinary alkalinization and EXTRIP hemodialysis indications.

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1. Methanol Poisoning

1.1 Sources and Mechanism

Methanol (wood alcohol) is found in windshield washer fluid, antifreeze formulations, industrial solvents, and illicitly produced spirits. Methanol itself has relatively low toxicity; the danger lies in its metabolites. Alcohol dehydrogenase (ADH) converts methanol to formaldehyde, which is then rapidly converted to formic acid by aldehyde dehydrogenase. Formic acid inhibits cytochrome oxidase (complex IV of the mitochondrial electron transport chain), producing cellular hypoxia, lactic acidosis, and selective damage to the optic nerve and basal ganglia.1 2

1.2 Lethal Dose

The minimum lethal dose is approximately 1 mL/kg of pure methanol (about 60–240 mL in adults), though as little as 15 mL has been reported to cause blindness and 30 mL has caused death.

1.3 Clinical Presentation

PhaseTimeFeatures
Early0–12 hoursInebriation similar to ethanol; headache; nausea; GI distress. May be asymptomatic during this “latent period” while methanol is being metabolized.
Latent period12–24 hoursRelative improvement; methanol being converted to formic acid
Late/Toxic18–48 hoursSevere metabolic acidosis (elevated anion gap); visual disturbances (“snowfield” vision, blurred vision, photophobia, blindness); Kussmaul respirations; altered mental status → coma → death

1.4 Diagnostic Evaluation

TestFinding
Osmol gapElevated early (methanol contributes to osmol gap)
Anion gapElevated late (formic acid accumulation); inversely related to osmol gap over time
Methanol levelConfirm diagnosis; level > 20 mg/dL generally warrants treatment; > 50 mg/dL is severe
LactateElevated (formic acid inhibits oxidative metabolism)
ABG/VBGSevere metabolic acidosis with respiratory compensation
FundoscopyOptic disc hyperemia, papilledema (if visual toxicity)

1.5 Management

1.5.1 Fomepizole (4-Methylpyrazole) — Antidote of Choice

Fomepizole competitively inhibits alcohol dehydrogenase, blocking conversion of methanol to formaldehyde. It is the preferred antidote due to predictable pharmacokinetics, ease of dosing, and lack of CNS depression.1 3

ComponentProtocol
Loading dose15 mg/kg IV in 100 mL NS over 30 minutes
Maintenance10 mg/kg IV every 12 hours for 4 doses
After 48 hoursIncrease to 15 mg/kg every 12 hours (fomepizole induces its own metabolism)
During hemodialysisDose every 4 hours (fomepizole is dialyzable)
Continue untilMethanol level < 20 mg/dL AND acidosis resolved AND patient clinically improved

Indications for fomepizole:

  • Methanol level > 20 mg/dL
  • Strong clinical suspicion of methanol ingestion with osmol gap > 10 or anion gap metabolic acidosis
  • History of methanol ingestion with any visual symptoms

Ethanol (as ADH inhibitor) may be used when fomepizole is unavailable:

  • Loading dose: 0.8 g/kg IV (10% ethanol in D5W) or orally
  • Target serum ethanol: 100–150 mg/dL
  • Disadvantages: CNS depression, hypoglycemia, difficulty maintaining target level, requires ICU monitoring

1.5.2 Hemodialysis

Hemodialysis is the definitive treatment for removing methanol and its toxic metabolites. Recommendations from the extracorporeal treatments workgroup:4

IndicationRecommendation
Methanol level > 50 mg/dLHemodialysis recommended
Severe metabolic acidosis (pH < 7.15)Hemodialysis recommended
Visual disturbancesHemodialysis recommended
Renal failure (inability to clear methanol/formate)Hemodialysis recommended
Clinical deterioration despite antidote therapyHemodialysis recommended
Methanol level > 20 mg/dL with acidosis or symptomsHemodialysis strongly suggested

Continue hemodialysis until: methanol level < 20 mg/dL, acidosis resolved, and clinical improvement.

1.5.3 Adjunctive Therapy

AgentRationaleDose
Folic acid (folinic acid/leucovorin preferred)Enhances formic acid metabolism to CO₂ and water50 mg IV every 6 hours for 24 hours (or folic acid 50 mg IV q6h)
Sodium bicarbonateTreat severe acidosis; maintain pH > 7.201–2 mEq/kg IV bolus; infusion as needed

2. Ethylene Glycol Poisoning

2.1 Sources and Mechanism

Ethylene glycol is found in automotive antifreeze, de-icing solutions, and industrial coolants. It is metabolized by ADH to glycoaldehyde, then to glycolic acid (the primary source of the anion gap), then to glyoxylic acid, and finally to oxalic acid. Oxalic acid chelates calcium, forming calcium oxalate crystals that deposit in renal tubules and other tissues, causing acute kidney injury.1 2 5

2.2 Lethal Dose

The minimum lethal dose is approximately 1–1.5 mL/kg (roughly 100 mL in adults), though survival has been reported with much larger ingestions when treated early.

2.3 Clinical Stages

StageTimeFeatures
Stage 1 — CNS0.5–12 hoursInebriation (without ethanol odor), nausea, vomiting; may appear “drunk” without smelling of alcohol; elevated osmol gap; mild acidosis developing
Stage 2 — Cardiopulmonary12–36 hoursSevere anion gap metabolic acidosis; tachycardia; hypertension → hypotension; pulmonary edema; multiorgan failure; hypocalcemia (calcium chelated by oxalate); QTc prolongation
Stage 3 — Renal24–72 hoursOliguric or anuric renal failure; flank pain; calcium oxalate crystalluria (envelope-shaped or needle-shaped crystals on urinalysis under polarized light); hematuria

2.4 Diagnostic Clues

FindingSignificance
Elevated osmol gap (early) → Elevated anion gap (late)Characteristic temporal pattern
Calcium oxalate crystals on urinalysisHighly suggestive (envelope/octahedral = monohydrate; needle-shaped = dihydrate); NOT always present
HypocalcemiaCalcium chelation by oxalic acid; can cause tetany, QTc prolongation, cardiac arrhythmias
Fluorescence of urine under Wood lampUnreliable; sodium fluorescein is an additive in some but not all antifreeze products
Ethylene glycol levelConfirmatory; > 20 mg/dL warrants treatment

2.5 Management

Treatment mirrors methanol poisoning with the following key differences:1 3 5

2.5.1 Fomepizole

Protocol is identical to methanol (see Section 1.5.1). Fomepizole blocks the initial metabolism step, preventing formation of toxic metabolites.

2.5.2 Hemodialysis

Recommendations from the extracorporeal treatments workgroup:6

IndicationRecommendation
Ethylene glycol level > 50 mg/dLHemodialysis recommended
Severe metabolic acidosis (pH < 7.30)Hemodialysis recommended
Acute kidney injuryHemodialysis recommended
Deterioration despite fomepizole therapyHemodialysis recommended
Level > 20 mg/dL with acidosis or renal injuryStrongly consider hemodialysis

Note on modern approach: If fomepizole is administered early (before significant metabolite accumulation), and the patient has normal renal function and no significant acidosis, hemodialysis may potentially be avoided even with moderately elevated ethylene glycol levels. The kidneys will gradually eliminate the parent compound while fomepizole prevents toxic metabolite formation. However, this strategy requires careful monitoring and toxicology consultation.3

2.5.3 Adjunctive Therapy

AgentRationaleDose
Thiamine (vitamin B₁)Cofactor for metabolism of glyoxylic acid to non-toxic α-hydroxy-β-ketoadipic acid100 mg IV every 6 hours
Pyridoxine (vitamin B₆)Cofactor for metabolism of glyoxylic acid to glycine (non-toxic)50 mg IV every 6 hours
CalciumFor symptomatic hypocalcemia (tetany, QTc prolongation)Calcium gluconate 1–2 g IV; monitor ionized calcium
Sodium bicarbonateFor severe acidosis1–2 mEq/kg bolus; infusion as needed

3. Carbon Monoxide (CO) Poisoning

3.1 Sources and Mechanism

Carbon monoxide is a colorless, odorless gas produced by incomplete combustion. Sources include house fires, motor vehicle exhaust, gas heaters, charcoal grills, and generators used indoors. CO binds hemoglobin with approximately 200–250 times the affinity of oxygen, forming carboxyhemoglobin (COHb), which shifts the oxyhemoglobin dissociation curve to the left and impairs oxygen delivery to tissues. CO also binds cytochrome oxidase, disrupting cellular respiration, and triggers inflammatory cascades via oxidative stress and lipid peroxidation.7

3.2 Clinical Presentation

COHb LevelSymptoms (Non-Smoker)
< 10%May be asymptomatic; mild headache
10–20%Headache, nausea, dizziness, exertional dyspnea
20–30%Severe headache, impaired judgment, visual disturbances, fatigue
30–40%Confusion, syncope, tachycardia, tachypnea
40–50%Coma, seizures, cardiovascular instability
> 50%Cardiopulmonary failure, death

Important caveats:

  • Pulse oximetry is unreliable — standard pulse oximeters cannot distinguish COHb from oxyhemoglobin and will read falsely normal
  • Diagnosis requires co-oximetry (measured on ABG/VBG)
  • “Cherry red” skin color is a late/postmortem finding and is unreliable
  • Levels poorly correlate with severity — a patient with COHb of 15% may be sicker than one at 25% depending on exposure duration

3.3 CO Half-Life by Oxygen Therapy

Oxygen TherapyApproximate CO Half-Life
Room air (21% O₂)320 minutes (approximately 5–6 hours)
100% O₂ via non-rebreather mask60–90 minutes
Hyperbaric oxygen (HBO) at 2.5–3 ATA20–30 minutes

3.4 Management

InterventionDetails
Remove from exposureImmediate; ensure scene safety for responders
100% oxygen via non-rebreather mask (NRB)Start immediately; continue until COHb < 5% and symptoms resolve (typically 6–8 hours of high-flow O₂)
IntubationFor coma, respiratory failure, or airway compromise
IV fluidsAs needed for hypotension
Cardiac monitoringCO poisoning can cause myocardial injury; obtain troponin and ECG
Hyperbaric oxygenSee Section 3.5

3.5 Hyperbaric Oxygen (HBO) — Indications

The role of HBO in CO poisoning remains debated, but it is generally recommended for the following indications:7 8

IndicationDetails
Loss of consciousness (at any point during exposure)Strongest indication
COHb level > 25% (> 15–20% in pregnancy)Level-based criterion
Cardiac ischemia or arrhythmiaCO-related myocardial injury
Severe metabolic acidosispH < 7.10
Persistent neurologic symptoms despite 4–6 hours of NRB oxygenOngoing CNS effects
Pregnancy with COHb > 15–20% or any symptomsFetal hemoglobin has higher CO affinity; lower threshold

Practical consideration: HBO requires transfer to a facility with a hyperbaric chamber. If transfer time exceeds 4–6 hours, the benefit may diminish. Continue 100% NRB oxygen during transport.

3.6 Delayed Neurologic Sequelae (DNS)

  • Occurs in 10–30% of significantly poisoned patients
  • Onset: days to weeks after exposure (classically 2–40 days)
  • Features: cognitive deficits, personality changes, parkinsonism, memory impairment, dementia
  • Risk factors: loss of consciousness, prolonged exposure, age > 36, COHb > 25%
  • HBO may reduce the incidence of DNS (based on the Weaver et al. randomized trial), though evidence remains mixed8

4. Cyanide Poisoning

4.1 Sources

  • House fires (combustion of synthetic materials — polyurethane, nylon, wool, silk produces hydrogen cyanide)
  • Industrial exposure (metal plating, mining, chemical manufacturing)
  • Ingestion (cyanide salts, acetonitrile-based nail polish removers, bitter almond extract)
  • Iatrogenic (prolonged/high-dose nitroprusside infusion)
  • Plants (amygdalin in bitter almonds, apricot/peach pits, cassava)

4.2 Mechanism

Cyanide binds to cytochrome oxidase (complex IV), halting aerobic metabolism. Cells switch entirely to anaerobic glycolysis, producing profound lactic acidosis. The brain and heart are most vulnerable due to high oxygen demand.9

4.3 Clinical Presentation

  • Early: Headache, anxiety, confusion, tachycardia, tachypnea, hypertension
  • Progressive: Bradycardia, hypotension, seizures, coma, apnea, cardiovascular collapse
  • Classic finding: Lactic acidosis with high mixed venous oxygen saturation (cells cannot utilize oxygen; venous blood remains oxygenated) — “arterialization” of venous blood
  • Bitter almond odor: Present in only 40–60% of the population (genetic ability to detect)

4.4 Cyanide Antidote Kits

4.4.1 Hydroxocobalamin (Cyanokit) — Preferred First-Line Antidote

Hydroxocobalamin (vitamin B12a) directly binds cyanide to form cyanocobalamin (vitamin B12), which is non-toxic and renally excreted.9 10

ComponentProtocol
Adult dose5 g IV over 15 minutes
Pediatric dose70 mg/kg IV (max 5 g) over 15 minutes
Repeat doseMay give a second 5 g dose if inadequate response
AdvantagesSafe in smoke inhalation (no methemoglobin formation); can be given empirically; rapid onset; safe even if cyanide is NOT the cause
Side effectsRed discoloration of skin, urine, and mucous membranes (lasts 2–3 days); may interfere with colorimetric laboratory assays (CO-oximetry, lactate, creatinine, glucose) for 24–48 hours

4.4.2 Sodium Thiosulfate

Acts as a sulfur donor for rhodanese-mediated conversion of cyanide to non-toxic thiocyanate.9

ComponentProtocol
Adult dose12.5 g IV (50 mL of 25% solution) over 10–20 minutes
Pediatric dose400 mg/kg IV (max 12.5 g)
OnsetSlow (30–60 minutes); often used as adjunct to hydroxocobalamin

4.4.3 Nitrite-Based Cyanide Antidote Kit (Traditional)

The traditional kit (Taylor Pharmaceuticals) contains amyl nitrite pearls, sodium nitrite, and sodium thiosulfate. Nitrites generate methemoglobin, which preferentially binds cyanide (forming cyanmethemoglobin).9

AgentDoseLimitation
Amyl nitrite (inhaled)Crush pearl, inhale for 30 sec of each minuteTemporizing measure only; hypotension risk
Sodium nitrite (3%, 10 mL)300 mg IV (10 mL) over 5 minutes (adult); pediatric: 0.2 mL/kg (max 10 mL)Contraindicated in smoke inhalation (concurrent COHb + MetHb = severe oxygen-carrying deficit); causes hypotension
Sodium thiosulfateAs aboveAdjunct

In fire-related cyanide exposure: Use hydroxocobalamin (not nitrites) because patients likely have concurrent CO poisoning, and inducing methemoglobinemia in a patient with elevated COHb is dangerous.


5. Organophosphate and Nerve Agent Poisoning

5.1 Mechanism

Organophosphates (OPs) and nerve agents irreversibly inhibit acetylcholinesterase (AChE), causing accumulation of acetylcholine at muscarinic and nicotinic receptors and in the CNS. “Aging” occurs when the OP-enzyme bond becomes permanent (timing varies by agent: soman ages within minutes; most agricultural OPs age over 24–48 hours).11 12

5.2 Clinical Features — SLUDGE/DUMBBBELS + Nicotinic + CNS

Receptor TypeMnemonicFeatures
MuscarinicDUMBBBELSDiarrhea, Urination, Miosis, Bronchospasm, Bronchorrhea, Bradycardia, Emesis, Lacrimation, Salivation
NicotinicFasciculations, muscle weakness, paralysis (including diaphragm), tachycardia, hypertension, mydriasis
CNSSeizures, coma, respiratory depression

The primary cause of death is respiratory failure from bronchorrhea, bronchospasm, and diaphragmatic paralysis.

5.3 Decontamination

  • Remove all clothing
  • Wash skin with soap and copious water (dilute hypochlorite for nerve agents)
  • Protect healthcare workers with appropriate PPE (gown, gloves, respiratory protection)
  • Activated charcoal for oral ingestion if within 1 hour (OP adsorption is variable)

5.4 Pharmacologic Management

5.4.1 Atropine — Muscarinic Antagonist (Primary Treatment)

ComponentProtocol
Initial dose2 mg IV (adult); pediatric: 0.05 mg/kg (minimum 0.1 mg)
TitrationDouble the dose every 5 minutes until secretions dry (2 mg → 4 mg → 8 mg → 16 mg → 32 mg…)
EndpointDrying of bronchial secretions (the most important endpoint); clearing of bronchospasm; heart rate is NOT the endpoint
Massive exposureMay require tens to hundreds of milligrams of atropine over the first 24 hours
Infusion10–20% of loading dose per hour once stabilized
DO NOTAtropine does NOT reverse nicotinic effects (weakness, fasciculations, paralysis)

5.4.2 Pralidoxime (2-PAM) — Oxime Reactivator

Pralidoxime reactivates AChE before aging occurs, restoring function at nicotinic junctions (muscle strength, diaphragm function).11 12

ComponentProtocol
Loading dose1–2 g IV over 15–30 minutes (adult); pediatric: 25–50 mg/kg (max 1 g)
Infusion500 mg/hour (adult) continuous; pediatric: 10–20 mg/kg/hour
ContinueFor at least 24 hours after atropine is no longer needed and patient has clinical improvement
TimingMost effective if given within 24–48 hours of exposure (before aging occurs)
Side effectsHypertension, tachycardia, muscle rigidity (if infused too rapidly), headache

5.4.3 Seizure Management

AgentDose
Benzodiazepines (first-line)Diazepam 5–10 mg IV or midazolam 5–10 mg IM
Repeat as neededEvery 5–10 minutes
Avoid phenytoinIneffective for OP-induced seizures
Military autoinjectorsDiazepam 10 mg IM available in military MARK I/DuoDote kits

5.5 Intermediate Syndrome

Occurs 24–96 hours after exposure; characterized by proximal muscle weakness, cranial nerve palsies, and respiratory failure. Requires continued respiratory support and pralidoxime. Not prevented by atropine.11


6. Iron Poisoning

6.1 Toxic Doses

Dose (mg/kg of elemental iron)Expected Severity
< 20 mg/kgNon-toxic
20–60 mg/kgMild to moderate toxicity
> 60 mg/kgSevere toxicity
> 120 mg/kgPotentially lethal

Elemental iron content by salt:

Iron Salt% Elemental Iron
Ferrous sulfate20%
Ferrous gluconate12%
Ferrous fumarate33%

6.2 Clinical Stages

StageTimeFeatures
Stage 10–6 hoursGI toxicity: vomiting, diarrhea (may be hemorrhagic), abdominal pain
Stage 26–24 hoursApparent improvement (“quiescent phase”); patient may seem to improve while systemic iron absorption continues
Stage 312–48 hoursSystemic toxicity: shock, metabolic acidosis (AGMA), hepatic failure, coagulopathy, renal failure
Stage 42–5 daysHepatic necrosis (if it occurs)
Stage 52–6 weeksGI scarring and strictures (pyloric/gastric outlet obstruction)

6.3 Diagnostic Evaluation

TestInterpretation
Serum iron level (4–6 hours post-ingestion)< 300 mcg/dL: unlikely significant toxicity; 300–500 mcg/dL: moderate toxicity; > 500 mcg/dL: severe toxicity; > 1,000 mcg/dL: potentially lethal
Abdominal radiographIron tablets are radiopaque; can confirm ingestion and monitor decontamination
Total iron binding capacity (TIBC)NOT reliable in acute overdose (falsely elevated); do NOT use the “serum iron > TIBC” rule
WBC > 15,000 or glucose > 150 mg/dLPredictive of iron level > 300 mcg/dL (screening tool)

6.4 Management

InterventionDetails
Activated charcoalNOT effective (iron is not adsorbed)
Whole bowel irrigationRecommended for significant iron ingestion; PEG-ELS until rectal effluent is clear and tablets no longer visible on radiograph
DeferoxamineSee Section 6.5
IV fluidsAggressive resuscitation for hypovolemia and shock
VasopressorsFor refractory shock

6.5 Deferoxamine — Iron Chelation Therapy

Deferoxamine chelates free iron, forming ferrioxamine (water-soluble, renally excreted, producing “vin rose” or pinkish-orange urine).13

ComponentProtocol
Dose15 mg/kg/hour IV continuous infusion
Maximum rate15 mg/kg/hour (higher rates associated with hypotension)
Maximum duration24 hours (longer infusions associated with ARDS)
EndpointResolution of clinical toxicity, clearing of “vin rose” urine, declining iron levels, resolution of acidosis
Side effectsHypotension (rate-related), ARDS (prolonged infusion > 24h), Yersinia enterocolitica sepsis (iron-dependent organism), urine discoloration

Indications for deferoxamine:

  • Serum iron level > 500 mcg/dL
  • Severe clinical toxicity (shock, metabolic acidosis, altered mental status) at any level
  • Serum iron > 350 mcg/dL with significant symptoms

7. Caustic Ingestions (Acids and Alkalis)

7.1 Mechanisms

TypeCommon AgentsInjury Pattern
Alkali (base)Drain cleaners (NaOH, KOH), oven cleaners, bleach (concentrated), button batteriesLiquefactive necrosis — deep, penetrating injury; esophageal injury predominates; higher risk of perforation
AcidToilet bowl cleaners (HCl), battery acid (H₂SO₄), rust removersCoagulation necrosis — superficial coagulum may limit initial depth (but does NOT prevent full-thickness injury with strong acids); gastric injury often predominates (pylorospasm traps acid)

7.2 Management

InterventionDetails
DO NOT induce vomitingRisk of re-exposure of esophagus to caustic
DO NOT give activated charcoalNot effective; obscures endoscopy; risk of vomiting
DO NOT attempt neutralization (acid for base or vice versa)Exothermic reaction causes thermal injury
DO NOT place NGT blindlyRisk of perforation
NPO statusUntil evaluation complete
IV fluidsResuscitation as needed
Airway assessmentStridor, voice changes, drooling suggest airway edema; early intubation if any concern (direct laryngoscopy preferred; small ETT may be needed)
CT of neck/chest/abdomenMay identify perforation, mediastinitis, or full-thickness injury
EndoscopyWithin 12–24 hours (optimally within 24 hours; avoid after 48 hours due to increased perforation risk during healing phase)

7.3 Endoscopic Grading (Zargar Classification)

GradeEndoscopic FindingsPrognosis
0NormalNo injury
1Edema, erythema of mucosaExcellent; no stricture risk
2ASuperficial ulceration, friability, hemorrhage, exudatesLow stricture risk (< 5%)
2BDeep discrete or circumferential ulcerationModerate stricture risk (up to 50%)
3AFocal necrosis (small areas)High stricture risk (> 65%); perforation risk
3BExtensive necrosisPerforation likely; may require surgery; high mortality

7.4 Button Battery Ingestion

Requires special mention as a unique caustic emergency, particularly in pediatric patients:

  • Esophageal impaction is a surgical emergency — lithium button batteries generate hydroxide ions via electrolysis, causing alkali burns that can perforate within 2 hours
  • Obtain chest/abdominal radiograph immediately to locate the battery
  • If lodged in esophagus: immediate endoscopic removal (within 2 hours)
  • Pre-removal: honey (10 mL every 10 minutes if > 12 months old and able to swallow) or sucralfate to mitigate ongoing tissue injury while awaiting removal
  • If past the esophagus: most will pass spontaneously; follow with serial radiographs; surgery only if symptomatic or not progressing

8. Local Anesthetic Systemic Toxicity (LAST)

8.1 Mechanism

Local anesthetic systemic toxicity occurs when plasma levels of local anesthetics exceed a toxic threshold, typically from accidental intravascular injection, excessive dosing, or rapid absorption. Local anesthetics block sodium channels in the CNS and cardiovascular system.14

8.2 Clinical Presentation

Toxicity progresses through CNS then cardiovascular stages:

PhaseFeatures
CNS excitation (early)Perioral numbness, metallic taste, tinnitus, agitation, tremor, dizziness
CNS depressionSeizures → CNS depression → coma → respiratory arrest
CardiovascularHypertension and tachycardia (early) → bradycardia → conduction blocks → wide-complex arrhythmias → asystole

Bupivacaine is the most cardiotoxic local anesthetic (high affinity for cardiac sodium channels, slow dissociation).

8.3 Intravenous Lipid Emulsion (ILE) Protocol — LAST Treatment

The lipid emulsion protocol for LAST is the most well-established indication for ILE therapy in toxicology.14 15

Protocol (20% Lipid Emulsion — e.g., Intralipid 20%)

StepProtocol
Bolus1.5 mL/kg of 20% lipid emulsion IV over 2–3 minutes
Infusion0.25 mL/kg/min for 30–60 minutes
Repeat bolusIf cardiovascular instability persists, may repeat bolus (1.5 mL/kg) one or two times at 5-minute intervals
Increase infusionMay double infusion rate to 0.5 mL/kg/min if blood pressure remains low
Maximum doseApproximately 12 mL/kg total (over first 30 minutes)

Mechanism of ILE: Creates a “lipid sink” that sequesters lipophilic local anesthetic molecules from tissue binding sites, and may provide a direct myocardial energy substrate.

Additional LAST Management

InterventionDetails
Airway managementIntubate for seizures or respiratory failure
SeizuresBenzodiazepines first-line; small doses of propofol acceptable; avoid large propofol doses (additional cardiac depression)
EpinephrineUse reduced doses (≤ 1 mcg/kg); standard ACLS doses of epinephrine may worsen toxicity
AVOIDVasopressin, calcium channel blockers, beta-blockers, lidocaine (additional sodium channel blockade), and local anesthetics of any kind
CPRProlonged resuscitation may be warranted — patients can recover even after prolonged arrest if ILE is administered
ECMO/bypassFor refractory cardiac arrest

9. Sympathomimetic Toxicity (Cocaine and Methamphetamine)

9.1 Clinical Presentation

Cocaine and amphetamines produce a sympathomimetic toxidrome through different mechanisms (cocaine: reuptake inhibition and sodium channel blockade; amphetamines: increased monoamine release and reuptake inhibition).16

FeatureDetails
CardiovascularHypertension, tachycardia, acute coronary syndrome (vasospasm + thrombosis), aortic dissection, arrhythmias
CNSAgitation, psychosis, seizures, intracranial hemorrhage, hyperthermia
OtherRhabdomyolysis, disseminated intravascular coagulation, mesenteric ischemia

9.2 Management Principles

InterventionDetails
BenzodiazepinesFirst-line for ALL sympathomimetic emergencies: agitation, hypertension, tachycardia, seizures, chest pain. Diazepam 5–10 mg IV or midazolam 5 mg IV/IM; repeat as needed
Active coolingFor hyperthermia; target core temperature < 39°C
NitroglycerinFor cocaine-associated chest pain/ACS
PhentolamineAlpha-blocker; 5 mg IV for refractory hypertension
AVOID beta-blockersContraindicated in cocaine toxicity — “unopposed alpha stimulation” may worsen hypertension and coronary vasospasm. This applies to all beta-blockers including labetalol (its alpha-blocking component is insufficient to prevent the phenomenon)
Sodium bicarbonateFor cocaine-induced QRS widening (sodium channel blockade effect)
IV fluidsAggressive hydration for rhabdomyolysis

10. Enhanced Elimination Techniques

10.1 Urinary Alkalinization — Complete Protocol

Urinary alkalinization (formerly “alkaline diuresis”) enhances renal excretion of weak acids by ion trapping in the renal tubule.17

Solution: 150 mEq NaHCO₃ (three 50-mEq ampules) + 40 mEq KCl in 1 L D5W

Rate: 250 mL/hour initially; titrate to urine output 2–3 mL/kg/hour and urine pH 7.5–8.0

Monitoring:

  • Urine pH every 1–2 hours (goal: 7.5–8.0)
  • Serum pH every 2–4 hours (goal: 7.45–7.55; do NOT exceed 7.60)
  • Serum potassium every 2 hours (goal: ≥ 4.0 mEq/L; hypokalemia is the most common reason for failure to alkalinize urine)
  • Fluid balance, electrolytes, clinical status

Indications:

AgentNotes
SalicylatesPrimary indication; significantly enhances renal clearance
PhenobarbitalAlternative to MDAC or hemodialysis for mild-moderate cases
ChlorpropamideEnhances elimination
MethotrexatePrevents crystalluria and enhances elimination
Chlorophenoxyacetic acid herbicides (e.g., 2,4-D)Significantly enhances elimination

10.2 Hemodialysis in Poisoning — EXTRIP Recommendations

The following table summarizes the key recommendations from the extracorporeal treatments in poisoning (EXTRIP) workgroup for the most clinically relevant toxins:4 6 18 19 20 21 22

SubstanceHemodialysis Recommended WhenEXTRIP Recommendation Strength
MethanolLevel > 50 mg/dL; visual symptoms; severe acidosis (pH < 7.15); renal failureStrong
Ethylene glycolLevel > 50 mg/dL; severe acidosis (pH < 7.30); acute kidney injuryStrong
SalicylateLevel > 100 mg/dL; altered mental status; pulmonary edema; severe acidosis (pH < 7.20); renal failureStrong
LithiumLevel > 4.0 mEq/L; significant neurologic symptoms; renal failure; level > 2.5 with renal impairmentStrong
PhenobarbitalProlonged coma expected; hemodynamic instability despite supportive careStrong
TheophyllineAcute level > 100 mg/L; chronic level > 60 mg/L; seizures; life-threatening arrhythmia; rising level despite MDACStrong
Valproic acidLevel > 900 mg/L; cerebral edema; hemodynamic instability; level > 1,300 mg/L in acute ingestionStrong
MetforminLactate > 20 mmol/L; pH ≤ 7.0; refractory shock; failure of standard measuresStrong
CarbamazepineRefractory seizures; life-threatening arrhythmia; prolonged coma despite MDACConditional
AcetaminophenLevel > 900 mcg/mL with acidosis; mitochondrial dysfunction (early elevated lactate and acidosis with very high levels)Conditional
DabigatranLife-threatening bleeding when idarucizumab unavailableConditional
IsopropanolRefractory hypotension; level > 400 mg/dL with clinical deteriorationConditional

10.3 Continuous Renal Replacement Therapy (CRRT)

CRRT (CVVH, CVVHD, CVVHDF) provides lower clearance rates than intermittent hemodialysis but may be useful when:18

  • Patient is hemodynamically unstable and cannot tolerate intermittent HD
  • Substance has significant rebound (lithium, metformin) — CRRT may be continued after intermittent HD to prevent rebound
  • Intermittent HD is unavailable

CRRT alone is generally NOT the preferred modality — intermittent hemodialysis provides far superior clearance for most dialyzable toxins.



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