Ethanol can be administered by the oral, nasogastric or intravenous route to maintain a blood ethanol concentration of 100-150 mg/dl (22-33 mol/L)
Oral or Nasogastric:
- Loading dose = 1.8 ml/kg of 43% ethanol, or 3 x 40ml shots of vodka in a 70 Kg adult. (No need to load if already under the influence!
- Maintenance = 0.2 – 0.4 ml/kg/hour of 43% ethanol, or 40ml shot each hour.
- Loading dose = 8 ml/kg of 10% ethanol
- Maintenance = 1-2 ml/kg/hour of 10% ethanol
- Depending on your institution the pharmacist will have to make this up otherwise is is made by adding 100ml of 100% ethanol to 900ml of 5% dextrose.
- The maintenance dosing will vary for each patient.
- It can cause hypoglycaemia in the paediatric population therefore, monitor BSLs.
- Maintain ethanol therapy until the toxic alcohol has been definitively treated with haemodialysis
- Barceloux DG, Krenzelok EK, Olson K et al. American Academy of Clinical Toxicology Practice Guidelines on the Treatment of Ethylene Glycol Poisoning. Journal of Toxicology – Clinical Toxicology 1999; 37(5):537-560.
- Lepik KJ, Levy AR, Sobolev BG et al. Adverse drug events associated with the antidotes for methanol and ethylene glycol poisoning: a comparison of ethanol and fomepizole. Annals of Emergency Medicine 2009; 53:439-450.