Circumstances of absorption:
(1) ingestion of rubbing alcohol
(2) prolonged contact on denuded skin, as after a burn
(3) accidental infusion (when mistaken for saline flushing solution)
Clinical findings:
(1) CNS depression, ranging from lethargy to coma
(2) hypotension, tachycardia (usually) or bradycardia, and asystole
(3) breath odor of rubbing alcohol or acetone
(4) gastrointestinal bleeding
Laboratory findings:
(1) increased osmolal gap
(2) ketosis, with positive urine acetone (absence is evidence against isopropanol ingestion)
(3) metabolic acidosis is rare
A serum level of isopropanol is approximately equivalent to twice that level of ethanol. Serum levels > 100 mg/dL is associated with coma.
The half-life of isopropanol in the absence of ethanol or massive ingestion is 6-7 hours (may be about 10 hours in neonates after accidental infusion).
