Ethanol

Antiseptic: Liquid denatured alcohol: Topical: Apply 1-3 times/day as needed Therapeutic neurolysis (nerve or ganglion block): Dehydrated alcohol injection 98%: Intraneural: Dosage variable depending upon the site of injection (eg, trigeminal neuralgia: 0.05-0.5 mL as a single injection per interspace vs subarachnoid injection: 0.5-1 mL as a single injection per interspace); single doses >1.5 mL are seldom required. Note: Administer when pain is from malignant origin only. Replenishment of fluid and carbohydrate calories: Dehydrated alcohol infusion: Alcohol 5% and dextrose 5%: 1-2 L/day by slow infusion Septal ablation for HOCM (off-label use) (Maron, 2003; Sorajja, 2012): Intracoronary (via balloon catheter): Dosage variable depending on septal anatomy and rate of contrast wash-out: 1-3 mL of at least 95% concentration infused slowly into septal perforator. Note: Smaller amounts may reduce the size of the septal infarct and incidence of complications (eg, complete heart block). Treatment of methanol or ethylene glycol overdose (off-label use) (Barceloux 1999; Barceloux 2002): Note: IV administration is the preferred route; continue therapy until ethylene glycol and/or methanol is no longer detected or levels are and the patient is asymptomatic and metabolic acidosis has been corrected. If ethylene glycol and/or methanol levels are not available in a timely manner, continue therapy until the estimated time of clearance of ethylene glycol and/or methanol has elapsed and the patient is asymptomatic with a normal pH. If patient has coingested ethanol, measure the baseline serum ethanol concentration and adjust the ethyl alcohol loading dose based on results to achieve a serum ethanol level of ~100 mg/dL. Absolute ethyl alcohol [98% (196 proof) = 77.4 g EtOH/dL]: IV: Note: Contact the Poison Control Center for options related to compounding IV ethanol. Initial: 600-700 mg/kg [equivalent to 7.6-8.9 mL/kg using a 10% solution] Maintenance: Goal of therapy is to maintain serum ethanol levels >100 mg/dL. Nondrinker: 66 mg/kg/hour [equivalent to 0.83 mL/kg/hour using a 10% solution] Chronic drinker: 154 mg/kg/hour [equivalent to 1.96 mL/kg/hour using a 10% solution] Dosage adjustment for hemodialysis: Maintenance dose: Nondrinker: 169 mg/kg/hour [equivalent to 2.13 mL/kg/hour using a 10% solution] Chronic drinker: 257 mg/kg/hour [equivalent to 3.26 mL/kg/hour using a 10% solution] Oral: Note: Solution must be diluted to a ≤20% concentration (to reduce the risk of gastritis) with water or juice and administered orally or via a nasogastric tube. Due to the pharmacokinetics of alcohol (ethyl) it is critical that oral ethanol be administered precisely at 60-minute intervals. Initial: 600-700 mg/kg [equivalent to 0.78-0.9 mL/kg using a 98% solution] Maintenance: Goal of therapy is to maintain serum ethanol levels >100 mg/dL Nondrinker: 66 mg/kg/hour [equivalent to 0.09 mL/kg/hour using a 98% solution] Chronic drinker: 154 mg/kg/hour [equivalent to 0.20 mL/kg/