Isopropyl alcohol is unique amongst the toxic alcohols (e.g., ethylene glycol, methanol, etc) in that it causes an osmolar gap WITHOUT causing an anion gap. In addition, unlike the toxic alcohols listed above, it is the isopropanol itself which is toxic, rather than its metabolites. Therefore treatment of isopropyl alcohol ingestion with fomepizole (an alcohol dehydrogenase inhibitor) is not advised. Ketones will be positive as isopropyl alcohol is metabolized to acetone. At blood levels >400 mg/dL, isopropyl alcohol can cause hypotension and CNS depression, and since it is easily dialyzable, dialysis may be employed to hasten the elimination of isopropanol.Kitty Dukakis, wife of former presidential candidate Michael Dukakis, was once hospitalized after drinking a small amount of isopropyl alcohol.
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