Ethylene Glycol

(rINNM)
Ethylene Glycol Chemical formula

💊 Chemical information

Ethylene Alcohol; Etilen Glikol; Etilenglicol; Glikol etylenowy; Glycol. Ethane-1,2-diol.
Chemical formula: C2H6O2 = 62.07.
CAS — 107-21-1.

💊 Adverse Effects

Toxic effects arising from ingestion of ethylene glycol result from its major metabolites: aldehydes, glycolate, lactate, and oxalate. Clinical features may be divided into three stages depending on the time elapsed since ingestion. In the first 12 hours, the patient may show signs of drunkenness and experience nausea and vomiting. Convulsions and neurological defects may occur. From 12 to 24 hours, there may be tachycardia, mild hypertension, pulmonary oedema, and heart failure. Between 24 and 72 hours, patients with severe ethylene glycol poisoning may experience flank pain and renal involvement with associated decreased plasma concentrations of calcium and bicarbonate, metabolic acidosis, deposition of oxalate in tissues and kidney tubules, proteinuria, oxaluria, haematuria, and renal failure. There may be respiratory failure, cardiovascular collapse, and sometimes coma and death. The fatal dose is reported to be about 100 mL. Skin irritation and penetration have been reported after topical application. Diethylene glycol produces similar toxicity, except that there is no conversion to oxalate and there is greater nephrotoxicity. Poisoning has followed adulteration of medicinal products with diethylene glycol.
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5. Lewis LD, et al. Delayed sequelae after acute overdoses or poisonings: cranial neuropathy related to ethylene glycol ingestion. Clin Pharmacol Ther 1997; 61: 692–9
6. O’Brien KL, et al. Epidemic of pediatric deaths from acute renal failure caused by diethylene glycol poisoning. JAMA 1998; 279: 1175–80
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8. Hasbani MJ, et al. Encephalopathy and peripheral neuropathy following diethylene glycol ingestion. Neurology 2005; 64: 1273–5.

💊 Treatment of Adverse Effects

The stomach should be emptied by lavage if ingestion of ethylene glycol was within the preceding hour. Severe metabolic acidosis should be corrected. Hypocalcaemia may require correction with calcium gluconate in severe cases, although this is not usually done routinely because it may increase the formation of calcium oxalate crystals. Haemodialysis may be of value. Alcohol may be given by mouth or intravenously as it is a competitor of the metabolism of ethylene glycol. Alternatively fomepizole, an alcohol-dehydrogenase inhibitor, may be used for the treatment of ethylene glycol poisoning.
1. Harry P, et al. Ethylene glycol poisoning in a child treated with 4-methylpyrazole. Pediatrics 1998; 102: E31.
2. Barceloux DG, et al. American Academy of Clinical Toxicology practice guidelines on the treatment of ethylene glycol poisoning. Clin Toxicol 1999; 37: 537–60
3. Brent J, et al. Fomepizole for the treatment of ethylene glycol poisoning. N Engl J Med 1999; 340: 832–8
4. Borron SW, et al. Fomepizole in treatment of uncomplicated ethylene glycol poisoning. Lancet 1999; 354: 831
5. Baum CR, et al. Fomepizole treatment of ethylene glycol poisoning in an infant. Pediatrics 2000; 106: 1489–91
6. Brent J. Current management of ethylene glycol poisoning. Drugs 2001; 61: 979–88
7. Battistella M. Fomepizole as an antidote for ethylene glycol poisoning. Ann Pharmacother 2002; 36: 1085–9.

💊 Pharmacokinetics

Ethylene glycol is absorbed from the gastrointestinal tract and is metabolised, chiefly in the liver, by alcohol dehydrogenase. Its breakdown products account for its toxicity and include aldehydes, glycolate, lactate, and oxalate.
1. Sivilotti ML, et al. Toxicokinetics of ethylene glycol during fomepizole therapy: implications for management. Ann Emerg Med 2000; 36: 114–25.

💊 Uses

Ethylene glycol is commonly encountered in antifreeze solutions and has been used illicitly to sweeten some wines. Diethylene glycol has been used similarly.
Published May 08, 2019.