4-METHYLPYRAZOLE AND HEMODIALYSIS IN ETHYLENE-GLYCOL POISONING

Case Reports: Two patients severely intoxicated wish ethylene glycol b ecame anuric and were treated by hemodialysis and the antidote, 4-meth ylpyrazole. On admission, their plasma ethylene glycol concentrations were 0.42 and 3 g/L respectively and no alcohol war detected. The elim ination of 4-methylpyrazole in the dialysate represented 45% of the to tal body elimination. Clearances of 4-methylpyrazole by hemodialysis w ere 80 mL/min and 52 mL/min respectively. Results: In such cases, the authors propose infusion of a 4-methylpyrazole loading dose of 10-20 m g/kg before dialysis and intravenous infusion of 1-1.5 mg/kg/h during the 8-12 hours of hemodialysis to compensate the loss in dialysate.