Management overview for isopropyl alcohol poisoning

This monograph discusses the management of poisoning due to ingestion of the toxic alcohol, isopropyl alcohol. For management of poisonings due to the toxic alcohols, methanol and ethylene glycol, see Toxic alcohol poisoning: methanol and ethylene glycol.

Isopropyl alcohol (isopropanol) is found in hand sanitisers (at concentrations of 50 to 70%), disinfectants, some perfumes and window cleaners. Isopropyl alcohol poisonings most commonly occur in children due to accidental ingestion, and in patients who are ethanol-dependent.

Isopropyl alcohol poisoning causes rapid-onset, dose-related central nervous system (CNS) depression; it has twice the potency of ethanol. Isopropyl alcohol is metabolised to acetone; therefore, ketosis is the characteristic feature of toxicity with isopropyl alcohol. Toxic effects of isopropyl alcohol are prolonged if co-ingested with ethanol.

Management of isopropyl alcohol poisoning is supportive care; haemodialysis should only be considered for life-threatening poisonings. Although isopropyl alcohol causes an increase in the osmolar gap, a progressive severe metabolic acidosis does not occur, so the use of antidotes is not required.

Isopropyl alcohol poisonings occur primarily after ingestion and this route of exposure is the focus of this monograph. However, dermal contact and inhalational exposures can also result in systemic toxicity. Ocular exposure can cause damage to the eye, but is unlikely to cause systemic toxicity.