Isopropyl Alcohol (isopropanol, 2-propanol, CAS 67-63-0, C3H7OH) is a clear, colorless liquid with a fruity odor and a slightly bitter taste. IPA can be found in a wide range of consumer and commercial products, including rubbing alcohol, antifreeze, disinfectants, cleaning solutions, skin and hair care products, and hand sanitizers. IPA is a solvent that is commonly used in industrial applications. After ethanol, it is the second most commonly consumed alcohol. IPA exposures reported to US poison control centers have ranged between 15,000 and 21,000 cases per year. 3,18 There were 15,454 single substance exposures, with 85 percent being unintentional, 4 percent having moderate to major effects, and three deaths, indicating a low case-fatality rate.
Isopropyl Alcohol, also known as "rubbing alcohol," is a common solvent found in the home as a cooling ingredient in topical liniments. In 2003, the AAPCC received over 12,000 reports of isopropanol exposures in children aged 5 to 19. Alcohol isopropyl toxicity can occur through the dermal and inhalation routes, as in the case of misguided sponge baths for fever. Alcohol isopropyl is rapidly absorbed from the gastrointestinal tract, with peak plasma concentrations occurring within 30 minutes. Although oral ingestion is the most common route of exposure, absorption can also occur transdermally, rectally, or via inhalation. Children are particularly vulnerable to systemic symptoms caused by the dermal application of IPA used to treat fever. ADH is primarily metabolised into acetone in the liver. Acetone monooxygenase converts acetone to acetol (hydroxyacetone). Propylene glycol, methylglyoxal, lactate, formate, and acetate are other metabolic products. Many of these byproducts of metabolism are then converted to glucose. Acetone has a half-life of up to 24 hours and a peak plasma concentration between 7 and 30 hours after exposure. IPA exhibits first-order kinetics, with a half-life ranging from 2.5 to 8 hours. Isopropyl Alcohol acts as a direct CNS depressant and is twice as inebriating as ethanol. Acetone can also cause CNS depression. Concurrent respiratory depression and profound CNS depression are possible. Larger doses can cause hypotension due to peripheral vasodilation and decreased cardiac inotropy. 18 Topical application causes corneal de-epithelialization and dermal irritation. Clinical Characteristics Isopropyl Alcohol irritates mucosal surfaces and causes GI effects shortly after ingestion. Larger ingestions can cause nausea, vomiting, and abdominal pain, as well as hemorrhagic gastritis, hematemesis, and significant blood loss. 18 Pancreatitis, like other alcohols, is a potential side effect. Inhaling IPA can result in hemorrhagic tracheobronchitis and pulmonary edoema. The symptoms of CNS depression range from lethargy to stupor or coma. There have been reports of headaches, dizziness, ataxia, hypotonia, hyporeflexia, dysarthria, and seizures.18 Pupil size varies, but miosis is common. Respiratory depression, hypoxia, and aspiration pneumonitis are all associated with loss of consciousness. Very large ingestions can cause hypotension and hypothermia. Hypotension indicates severe poisoning with an increased risk of death. Injuries from prolonged immobilisation can result in compartment syndrome and rhabdomyolysis. ARF can be caused by myoglobinuria. As with other alcoholic beverages, hypoglycemia has not been reported with Isopropyl Alcohol. Dermal contact causes a defatting dermatitis with skin drying and cracking, and chemical burns can occur in paediatric patients. Ketosis without acidosis is a common finding after consuming IPA.
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