Treatment of Ethylene Glycol Poisoning with Intravenous 4-Methylpyrazole

Abstract
THE toxic effects of ethylene glycol result from its metabolic conversion by alcohol dehydrogenase into glycolic acid — a process that causes metabolic acidosis. Glycolate is then metabolized to oxalate, the apparent cause of the renal toxicity of ethylene glycol. Ethanol and methanol are also metabolized by alcohol dehydrogenase, and it is the formaldehyde and formic acid produced through this pathway that cause the toxic effects of methanol. The activity of alcohol dehydrogenase is markedly inhibited by 4-methylpyrazole in vitro1 2 3 4 and in vivo in both animals5 and humans.6 7 8 9 10 11 In studies in animals, 4-methylpyrazole has been shown to reduce or eliminate . . .