An 18-year-old man who had been found unresponsive and face down in his bed after spending the day working in his garage is brought to the hospital emergency department.He had not responded to naloxone administration given by the paramedics.His history reveals that he was despondent over the recent death of his father,with whom he enjoyed restoring antique automobiles.Laboratory results indicate negative serum acetone,elevated serum urea and creatinine,normal PO₂,decreased bicarbonate,increased PCO₂,and increased osmol gap and anion gap.Urinalysis indicated many oxalate crystals.Based on these laboratory results and the likely compound that has affected this individual,what is the best therapy?

Question

Quizplus · Accepted Answer

The laboratory results suggest that the individual has ingested ethylene glycol, which is commonly found in antifreeze, and can cause acute kidney injury and metabolic acidosis. The best therapy for ethylene glycol toxicity is fomepizole or ethanol administration to prevent the conversion of ethylene glycol into toxic metabolites. Increased naloxone dose, folate administration, and activated charcoal are not appropriate treatments for ethylene glycol toxicity.

An 18-Year-Old Man Who Had Been Found Unresponsive and Face