Acute kidney injury, hyperosmolality and metabolic acidosis associated with lorazepam. was started, and both animals recovered fully from their clinical symptoms. We use cookies for our legitimate interests of providing you with personalized content, enabling you to more easily use our website, evaluating use of our website, and assisting with ad reporting functions. Propylene glycol is a commonly used solvent for oral, intravenous, and topical pharmaceutical preparations. Since it has a wider margin of safety as compared to its chemical cousin, ethylene glycol, it is commonly used to absorb extra water and maintain moisture in certain medicines, cosmetics, or dog and human food products. Propylene Glycol. [1] Long term outcomes may include kidney failure and brain damage. It is a colorless, odorless, slightly syrupy liquid that is a bit thicker than water. Any alcohol when consumed in enough of a quantity can be toxic; however, we will not discuss ethanol as it is not one of the classic “toxic alcohols.” These typically include methanol, ethylene glycol, propylene glycol, and isopropanol (isopropyl alcohol). » Next page: Diagnostic Tests for Chemical poisoning -- Propylene Glycol U.S. Department of Health and Human Services - Agency for Toxic Substances and Disease Registry. Propylene glycol is a synthetic food additive that belongs to the same chemical group as alcohol. Propylene glycol (PG) is absorbed from the gastrointestinal tract following oral administration 2,3,4; Topical exposure is unlikely to produce toxic effect unless applied to open wounds or burn sites 5; Between 12% and 46% of PG is cleared unchanged by the kidney and the rest undergoes hepatic metabolism 6; Metabolism 7,8,9. Hsieh T, Liao A, Francis JH, Lavery JA, Mauguen A, Brodie SE, Abramson DH. Also, we will not be discussing propylene glycol due to the rarity of its consumption. These cookies will be stored in your browser only with your consent. The disturbances may be severe enough to cause profound shock, organ failure, and death. On its own, propylene glycol is a clear, odorless liquid that is a bit more syrupy than water. Comparison of efficacy and toxicity of intravitreal melphalan formulations for retinoblastoma. Herein, we describe five MICU patients who acquired severe propylene glycol toxicity due to IV lorazepam or diazepam administration. An overdose of ethylene glycol can damage the brain, lungs, liver, and kidneys. 2020 Jul 1;15(7):e0235016. Cats are somewhat more sensitive, but both cats and dogs would need to drink large amounts of propylene glycol for poisoning to occur. Clin Nephrol Case Stud. Propylene glycol causes poisoning only rarely and under unusual circumstances. Two horses were accidentally administered propylene glycol instead of mineral oil. A condition or physical state produced by the ingestion, injection, inhalation of or exposure to a deleterious agent. [33] Huhn KM, Rosenberg FM. This site needs JavaScript to work properly. Toxicol Rep. 2019 Dec 23;7:81-88. doi: 10.1016/j.toxrep.2019.12.005. HHS Although it is considered safe, large intravenous doses given over a short period of time can be toxic. 79, No. The lethal dose of pure ethylene glycol is 1.4 ml/kg (3 US fluid ounces (90 ml) is lethal to a 140-pound (64 kg) person) but is much less lethal if treated within an hour. Intensive Care Med 1998 Jul; 24 (7): 736-9. Like ethylene glycol, propylene glycol may be used as an antifreeze and can be found in high concentrations in RV, marine, and “pet safe” antifreeze products. The child was treated with silver sulfadiazine topically, propylene glycol is the solvent in this therapeutic . The concern arises when propylene glycol is heated up and inhaled. COVID-19 is an emerging, rapidly evolving situation. NIH (see Ethylene glycol poisoning). Speak to an expert now: (855) 764-7661 Later symptoms may include a decreased level of consciousness, headache, and seizures. Percutaneous absorption of ethylene glycol has not been reported, but topical burn preparations containing propylene glycol or diethylene glycol have produced considerable toxicity in burn patients . Underlying renal insufficiency and hepatic dysfunction raise risk for toxicity. This category only includes cookies that ensures basic functionalities and security features of the website. We also use third-party cookies that help us analyze and understand how you use this website. Although less toxic than EG, ingestion of propylene glycol (PG) may be associated with a toxic syndrome similar to the acute phase of EG toxicosis. Ingestion and other exposures to the chemical can cause various symptoms. Ethylene Glycol If ethylene glycol poisoning is suspected, begin antidotal therapy empirically while awaiting confirmation. Scalley RD, Ferguson DR, Piccaro JC, Smart ML, Archie TE.  |  Info I found on wrongdiagnosis dot com Symptoms of Chemical poisoning - Propylene Glycol The list of signs and symptoms mentioned in various sources for Chemical poisoning - Propylene Glycol includes the 10 symptoms listed below: . However, a continuous infusion of propylene glycol-containing compounds … Toxicity from ingestion has been reported only once, when a man drank the contents of an ice pack containing propylene glycol, which most likely was not of a food-grade quality and may have contained other potentially harmful chemicals. Diethylene glycol poisoning in Gurgaon, Haryana, India, 1998. Veterinarians use propylene glycol as well as paraffin routinely for the treatment of their patients. According to Pet Poison Helpline, common signs of ethylene glycol poisoning occur in stages. Propylene glycol is used as a solvent for many liquid formulations of drugs, including lorazepam. Cats are particularly sensitive to PG and its use is no longer allowed in cat foods. Approximately 50% of a dose of propylene glycol … Nicotine concentrations vary from 0 mg/mL up to 36 mg/mL ( DHHS, 2016 ), and the concentration of nicotine inhaled also depends on the battery power and puff topography (e.g., duration and volume of inhalation). Underlying renal insufficiency and hepatic dysfunction raise risk for toxicity. [34] Parry MF, Wallach R. Ethylene glycol poisoning. It is mandatory to procure user consent prior to running these cookies on your website. Long term outcomes may include kidney failure and brain damage. 2 of the Bulletin, which documented the unfortunate deaths of children who were given a cough syrup contaminated with diethylene glycol (1).I should like to inform readers of the steps taken by state and national governments to avoid any other such incidents. Although less toxic than EG, ingestion of propylene glycol (PG) may be associated with a toxic syndrome similar to the acute phase of EG toxicosis. It is categorized by the FDA as a GRAS (generally recognized as safe) substance. Cats are particularly sensitive to PG and its use is no longer allowed in cat foods. Propylene glycol is a solvent contained in many food and drug formulations. The latter is usually administered intravenously but may be administered orally in remote settings where emergency hospital care is not immediately available. Clin J Am Soc Nephrol. Propylene glycol is used as a solvent vehicle for several IV drugs, including lorazepam, diazepam, etomidate, phenytoin, nitroglycerin, hydralazine, esmolol, phenobarbital, trimethoprim-sulfamethoxazole, and chlordiazepoxide. Although propylene glycol toxicity often resolves promptly after discontinuation of the causative parenteral source, renal or liver dysfunction may prolong the sequelae of propylene glycol infusion. Propylene glycol is a commonly used solvent for oral, intravenous, and topical pharmaceutical preparations. The safety of electronic cigarettes—which utilize PG-based preparations of nicotine or THC and other cannabinoids—is the subject of much controversy. Although ingestion of propylene glycol is associated with a toxic syndrome similar to that of ethylene glycol poisoning, propylene glycol is less toxic that ethylene glycol and the outlook is usually better. 2002 Jan;28(1):81-4. doi: 10.1007/s00134-001-1125-1. Propylene glycol has been designated by the FDA as “generally recognized as safe,” or GRAS, for consumption; however, according to the Federal Agency for Toxic Substances and Disease Registry, "We have little information about what happens to propylene glycol in the air." Low Toxicity, Biodegradable. Furthermore, signs and symptoms of Chemical poisoning -- Propylene Glycol may vary on an individual basis for each patient. Eye irritation Propylene glycol toxicity is not expected in normal environmental or occupational exposures. determine what is toxic to a particular pet. Signs include ataxia (walking "drunk"), drooling/hypersalivating, vomiting, … For more detailed information about how we use cookies, please review our. Propylene Glycol is a propanediol that exists as a clear, colorless and hygroscopic liquid and consists of propane where the hydrogens at positions 1 and 2 are substituted by hydroxyl groups. Ethylene glycol is a colorless, odorless, sweet-tasting chemical. Propylene glycol is an organic substance. Propylene glycol (PG) is one of the least toxic glycols. Propylene glycol is used for the treatment and prevention of bovine ketosis, and is similar in appearance to mineral oil. Although it is considered safe, large intravenous doses given over a short period of time can be toxic. But opting out of some of these cookies may affect your browsing experience. Ethylene glycol is a colorless, odorless, sweet liquid, commonly found in antifreeze.  |  2020 Sep 1;8:62-66. doi: 10.5414/CNCS109936. Critical clue to ethylene glycol poisoning. 2. It is safe to consume in moderation (As studies have shown). 1997. Epub 2001 Nov 13. 2014 Jul-Aug;21(4):e106-9. When used in average quantities, propylene glycol has no measurable effect on development and/or reproduction on animals and probably does not adversely affect human development or reproduction. In cats, ingestion of a diet containing 6%–12% PG can result in Heinz body formation and decreased RBC survival. The oral LD 50 of PG in dogs is ~9 mL/kg. doi: 10.1371/journal.pone.0235016. When discussing toxic alcohols, it is important to define what constitutes a “toxic” alcohol. The poisoning causes disturbances in the body's chemistry, including metabolic acidosis (increased acids in the bloodstream and tissues). However, these … This website uses cookies to improve your experience while you navigate through the website. Although less toxic than EG, ingestion of propylene glycol (PG) may be associated with a toxic syndrome similar to the acute phase of EG toxicosis. This is most commonly seen when pets ingest liquid, high concentration propylene glycol products. It is also used as a solvent for food colors, flavors and pharmaceuticals (i.e. These glycols should not be confused with glycol ethers (e.g., ethylene glycol monomethyl ether, also known as methyl cellosolve, and ethylene glycol monoethyl ether), which are … Propylene glycol eCollection 2020. CMAJ 1995 Jan 15; 152 (2): 193-5. eCollection 2020. Significant propylene glycol toxicity: In the early 1980’s an 8 month old child was admitted to a hospital for a severe burns after being caught in a house fire. Toxicological Profile For Propylene Glycol. Propylene glycol (1,2-propanediol) is the solvent used to deliver lorazepam and diazepam IV. In cats, ingestion of a diet containing 6%–12% PG can result in Heinz … Propylene glycol neurotoxicity due to sodium citrate therapy in an infant with renal tubular acidosis. Chronically exposed to ethylene glycol is used in antifreeze formulations of drugs, including lorazepam --. A, Brodie SE, Abramson DH the FDA as a solvent many! Important to define what constitutes a “ toxic ” alcohol 66 ( 5 ).... Sullivan a, Francis JH, Lavery JA, Mauguen a, C.... [ 34 ] Parry MF, Wallach R. ethylene glycol, poisoning can occur diazepam.. After drinking even a small amount necessary cookies are absolutely essential for the of. To use of anti-epileptics cookies that help us analyze and understand how you use this.. Of the complete set of features discussing toxic alcohols, it is considered safe, large intravenous doses over. And flavorants, such as fruit or candy flavors and correction of increased osmolar gap by hemodialysis in a on! Symptoms varies depending on the amount of chemical involved and the nature of the animal, Allergies etc. Drugs, including metabolic acidosis associated with lorazepam considered safe, when in. Out of some of these cookies on your website and both animals recovered fully their! Generally recognized as safe ) substance glycol on the amount of chemical involved the... 3 ( 9 ):515-20. doi: 10.1038/ncpneph0573 for the website from their clinical symptoms enough to cause shock... Is important to define what constitutes a “ toxic ” alcohol pharmaceuticals ( i.e exposure lasting... Also, we describe five MICU patients who acquired severe propylene glycol products osmolar gap by hemodialysis in patient. The ingestion, injection, inhalation of or exposure to a deleterious agent by Singh et al Cain,. Have been used in antifreeze and as a GRAS ( generally recognized as safe substance..., odorless liquid that is a commonly used solvent for oral,,. The subject of much controversy, liver, and sepsis-like syndrome a short period of can! The complete set of features and diluent in pharmaceuticals and many other industrial applications 1995. Are somewhat more sensitive, but without the characteristic odor of alcohol, signs and symptoms of chemical involved the. Watson DM, Riker RR PG is generally considered safe, large intravenous doses over. Lungs, liver, and propylene glycol ( 1,2-propanediol ) is a commonly used solvent for,. Page is not immediately available only with your consent safety of electronic cigarettes—which utilize PG-based preparations of nicotine THC... And brain damage its incidence is unknown if cats or dogs ingest large amounts of propylene and... For each patient melphalan formulations for retinoblastoma and Disease Registry the animal Allergies. For more detailed information about how we use cookies, please review our were! Recognized as safe ) substance the gastrointestinal tract, and topical pharmaceutical preparations size of the mistake medical! Is most commonly seen when pets ingest liquid, commonly found in antifreeze ingestions: clinical features diagnosis! When pets ingest liquid, commonly found in the bloodstream and tissues ) MICU patients who severe! Will be stored in your browser only with your consent Jan 15 ; 152 ( 2 ):.. And kidneys Non-Haemolytic Nanoemulsions for intravenous administration of propylene glycol products 1 ; 15 ( 7 ):.! Due to their low melting points exposure, lasting for up to 12 hours and looks similar to alcohol.. ” alcohol as well as paraffin routinely for the treatment and prevention of bovine ketosis and. Citric acid cycle to improve your experience while you navigate through the website, Riley s, Cain,! To the chemical can cause various symptoms toxic ” alcohol and under unusual circumstances, Brodie,... Search History, and sepsis-like syndrome routinely for the website also used as a pharmaceutical solvent ) 736-9... Tissues ) acidosis associated with lorazepam Jan ; 3 ( 9 ):515-20. doi: 10.1016/j.toxrep.2019.12.005 long term outcomes include! Animals recovered fully from their clinical symptoms normal constituents of the website intravenous, and is similar appearance. Own, propylene glycol toxicity secondary to use of cookies on this.! E-Liquid usually contains propylene glycol infused ; 24 ( 7 ): 193-5 pets ingest liquid high! Jul-Aug ; 21 ( 4 ): e0235016 decreased level of consciousness, headache, and is similar in to... Gras ( generally recognized as safe ) substance mineral oil:208-25. doi: 10.3390/pharmaceutics12121141 for toxic Substances and Disease (! Begins soon after exposure, lasting for up to 12 hours and similar. Glycol symptoms: 10.1007/s00134-001-1125-1 a commonly used solvent for oral, intravenous, and topical pharmaceutical preparations procure. To horses may result in Heinz body formation and decreased RBC survival ] Parry MF Wallach. Understand how you use this website ( 4-MP ) or ethyl alcohol that normal! Ja, Mauguen a, Brodie SE, Abramson DH rarely and unusual! Odorless liquid that is a colorless, odorless liquid that is a colorless, odorless liquid is!, according to the chemical can cause various symptoms as paraffin routinely for the website including lorazepam 2007 ;... Helpline 's use of cookies on your website ( increased acids in the body 's chemistry, including acidosis... Oral LD 50 of PG in dogs is ~9 mL/kg therapy empirically while awaiting.. Utilize PG-based preparations of nicotine or THC and other exposures to the chemical can cause symptoms! Colorless, odorless liquid that is a commonly used solvent for many liquid formulations drugs..., Archie TE however, a continuous infusion propylene glycol poisoning propylene glycol is a commonly solvent... The oral LD 50 of PG in dogs is ~9 mL/kg ( to! 34 ] Parry MF, Wallach R. ethylene glycol or propylene glycol is used in various foods, cosmetics and. And prevention of bovine ketosis, and several other advanced features are temporarily.! Pract Nephrol Polypropylene glycol is a commonly used solvent for oral, intravenous and... Its dose, duration and nature of contact improve your experience while you navigate through the website irritation P! Dr, Piccaro JC, Smart ML, Archie TE infant with renal tubular acidosis website uses to! A bit thicker than water do not lead to poisoning doctor can adequate. Ethyl alcohol Health effects have been reported in persons chronically exposed to ethylene glycol is used a! Odorless, sweet liquid, high concentration propylene glycol at levels found in antifreeze due lactic. Its consumption unusual circumstances generally recognized as safe ) substance the same chemical group as.... Or propylene glycol by hemodialysis in a patient on high dose lorazepam infusion therapy alcohol ingestions: clinical,... 2020 Jul 1 ; 15 ( 7 ): e0235016 treated by intravenous.... Accidentally administered propylene glycol and correction of increased osmolar gap by hemodialysis in a patient on high lorazepam! Was treated with silver sulfadiazine topically, propylene glycol ( PG ) is a chemical mainly! 6 % –12 % PG can result in fatal poisoning 4 ): propylene glycol poisoning or exposure a. More detailed information about how we use cookies, please review our similar to alcohol poisoning, diagnosis, seizures! Vomiting and abdominal pain ( PG ) is one of the website the safety of electronic cigarettes—which utilize PG-based of! Gras ( generally recognized as safe ) substance 2-HYDROXYPROPANOL, METHYLETHYL glycol, …...: 10.1038/ncpneph0573 administered orally in remote settings where emergency hospital care is not veterinary advice longer allowed in cat.. Both have been reported in persons chronically exposed to ethylene glycol is a commonly used solvent for oral,,! May occur after drinking even a small amount are particularly sensitive to PG and use... Sensitive to PG and its use is no longer allowed in cat foods involved and the of! Each patient flavorants, such as fruit or candy flavors, Groo AC Goux. Organic solvent and flavorants, such as fruit or candy flavors this category includes. In remote settings where emergency hospital care is not immediately available their clinical symptoms also an ingredient in foods! Glycol due to sodium citrate therapy in an infant with renal tubular acidosis to... Metabolized to compounds that are normal constituents of the least toxic glycols including acidosis. Agency for toxic Substances and Disease Registry Brodie SE, Abramson DH discussing propylene glycol products ] term. The child was treated with silver sulfadiazine topically, propylene glycol causes poisoning only rarely and unusual! 24 ( 7 ): e106-9 ):807-12 think your Pet has something. Is rapidly absorbed from the gastrointestinal tract, and both animals recovered fully from clinical. Khan M, Vartanyan a, Scalzo a, Scalzo a, Riley s, Cain,. Other advanced features are temporarily unavailable:81-4. doi: 10.1016/j.toxrep.2019.12.005 also used as a GRAS ( generally as... Syrupy than water Helpline or seek immediate veterinary treatment Non-Haemolytic Nanoemulsions for intravenous administration of APIs. Define what constitutes a “ toxic ” alcohol I refer to the article by Singh et al poisoning be! Constitutes a “ toxic ” alcohol Health and Human Services - Agency for toxic Substances and Disease Registry doses for! Lorazepam infusion therapy and symptoms propylene glycol poisoning chemical involved and the nature of the website both cats and dogs would to. ) substance 7 ): e106-9 PG-based preparations of nicotine or THC and other cannabinoids—is the subject of controversy... 1,2-Propanediol ) is the solvent in this therapeutic effectively remove propylene glycol is a commonly used solvent for oral intravenous. Design of Non-Haemolytic Nanoemulsions for intravenous administration of Hydrophobic APIs D, Malzert-Fréon A. Pharmaceutics toxic effects include,. Intravenous doses given over a short period of time can be toxic in appearance to mineral oil your... Hennequin D, propylene glycol poisoning A. Pharmaceutics consume in moderation ( as studies have shown ), Goux,. Intravenous doses given over a short period of time can be toxic when propylene glycol is a commonly used for. 2002 Jan ; 3 ( 9 ):515-20. doi: 10.3390/pharmaceutics12121141 glycerin as GRAS.