CHAPTER 82 FOMEPIZOLE IN ETHYLENE GLYCOL POISONING

Fomepizole for the Treatment of Ethylene Glycol Poisoning

Brent J, McMartin K, Phillips S, et al. N Engl J Med. 1999;340(11):832–838

BACKGROUND

Ethylene glycol poisoning causes significant morbidity, including renal failure, damage to the central nervous system, and cardiovascular instability. Prior to this study the standard treatment of ethylene glycol poisoning included high-dose ethanol as a means of inhibiting the conversion of ethylene glycol into its toxic metabolites through alcohol dehydrogenase. Ethanol has concerning side effects including intoxication, hepatotoxicity, and hypoglycemia as well as a widely variable metabolism. Fomepizole is an inhibitor of alcohol dehydrogenase that, at the time of this study, was theorized to have similar clinical benefit as high-dose alcohol in the treatment of ethylene glycol poisoning without the toxic side effects.

OBJECTIVES

To determine the efficacy of fomepizole in the treatment of ethylene glycol poisoning.

METHODS

Prospective, open, multicenter study between 1995 and 1997.

Participants

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