Isopropyl Alcohol
Isopropyl alcohol is used widely as a solvent, an antiseptic, and a disinfectant and is commonly available in the home as a 70% solution (rubbing alcohol). It is often ingested by alcoholics as a cheap substitute for liquor. Unlike the other common alcohol substitutes methanol and ethylene glycol, isopropyl alcohol is not metabolized to highly toxic organic acids and therefore does not produce a profound anion gap acidosis. Hospitals sometimes color isopropyl alcohol with blue dye to distinguish it from other clear liquids; this has led abusers to refer to it as “blue heaven.”
Mechanism of toxicity
Isopropyl alcohol is a potent depressant of the CNS, and intoxication by ingestion or inhalation may result in coma and respiratory arrest. It is metabolized to acetone (dimethyl ketone), which may contribute to and prolong CNS depression.
Very large doses of isopropyl alcohol may cause hypotension secondary to vasodilation and possibly myocardial depression.
Isopropyl alcohol is irritating to the GI tract and commonly causes gastritis.
Pharmacokinetics. Isopropyl alcohol is well absorbed within 2 hours and quickly distributes into body water (volume of distribution, 0.6 L/kg). It is metabolized (half-life, 3–7 hours) by alcohol dehydrogenase to acetone.
Toxic dose. Isopropyl alcohol is an approximately two- to threefold more potent CNS depressant than ethanol.
Ingestion.
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