Propylene Glycol. A quarter pound of acetaminophen with propylene glycol on the side: A case report. No health effects have been reported in persons chronically exposed to ethylene glycol or propylene glycol at levels found in the environment. Clin Nephrol Case Stud. Editor I refer to the article by Singh et al. If cats or dogs ingest large amounts of propylene glycol, poisoning can occur. In fact, a diagnosis of ethylene glycol poisoning can only be confirmed after eliminating other causes of increased anion gap (or metabolic acidosis) as represented by the acronym MUDPILES (methanol, uremia, diabetic ketoacidosis, propylene glycol, isoniazid, lactic acidosis, ethylene glycol, and … 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. Stage 1: This occurs within 30 minutes to 12 hours and looks similar to alcohol poisoning. Am Fam Physician. Hantson P, Hassoun A, Mahieu P. Ethylene glycol poisoning treated by intravenous 4-methylpyrazole. 2. If cats or dogs ingest large amounts of propylene glycol, poisoning can occur. Intensive Care Med. The poisoning causes disturbances in the body's chemistry, including metabolic acidosis (increased acids in the bloodstream and tissues). Toxicity and death may occur after drinking even a small amount. Although it is considered safe, large intravenous doses given over a short period of time can be toxic. Propylene glycol (PG) is a commonly used solvent for oral, intravenous, and topical pharmaceutical agents. Hsieh T, Liao A, Francis JH, Lavery JA, Mauguen A, Brodie SE, Abramson DH. 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. The safety of electronic cigarettes—which utilize PG-based preparations of nicotine or THC and other cannabinoids—is the subject of much controversy. some. It is categorized by the FDA as a GRAS (generally recognized as safe) substance. [33] Huhn KM, Rosenberg FM. When ingested or administered in excess, propylene glycol causes lactic acidosis, which should not be treated with therapeutic regimes appropriate for ethylene glycol poisoning , , . Get the latest public health information from CDC: https://www.coronavirus.gov, Get the latest research information from NIH: https://www.nih.gov/coronavirus, Find NCBI SARS-CoV-2 literature, sequence, and clinical content: https://www.ncbi.nlm.nih.gov/sars-cov-2/. This depression appears similar to ethanol intoxication, but without the characteristic odor of alcohol. 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. An overdose of ethylene glycol can damage the brain, lungs, liver, and kidneys. It is believed that background concentrations of ethylene glycol in air, soil, surface and groundwater do not lead to poisoning. Cats are particularly sensitive to PG and its use is no longer allowed in cat foods. Although PG is generally considered safe, when used in high doses or for prolonged periods, PG toxicity can occur. The e-liquid usually contains propylene glycol and/or glycerin as a solvent and flavorants, such as fruit or candy flavors. Propylene glycol neurotoxicity due to sodium citrate therapy in an infant with renal tubular acidosis. Diethylene glycol poisoning in Gurgaon, Haryana, India, 1998. Propylene glycol, which is much less toxic than ethylene glycol, is metabolized to compounds that are normal constituents of the citric acid cycle. Herein, we describe five MICU patients who acquired severe propylene glycol toxicity due to IV lorazepam or diazepam administration. Ethylene glycol is a colorless, odorless, sweet liquid, commonly found in antifreeze. National Center for Biotechnology Information, Unable to load your collection due to an error, Unable to load your delegates due to an error. Prevention is best achieved by limiting the dose of propylene glycol infused. On its own, propylene glycol is a clear, odorless liquid that is a bit more syrupy than water. Propylene glycol toxicity is seen mainly in an inpatient setting with IV infusions that contai… [1] Long term outcomes may include kidney failure and brain damage. PLoS One. Propylene glycol (1,2-propanediol) is the solvent used to deliver lorazepam and diazepam IV. Comparison of efficacy and toxicity of intravitreal melphalan formulations for retinoblastoma. If ethylene glycol poisoning is suspected, begin antidotal therapy empirically while awaiting confirmation. This website uses cookies to improve your experience while you navigate through the website. Ethylene glycol poisoning. Propylene glycol is used for the treatment and prevention of bovine ketosis, and is similar in appearance to mineral oil. NIH 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: . Although propylene glycol toxicity is increasingly recognized and reported, its incidence is unknown. Propylene glycol toxicity is not expected in normal environmental or occupational exposures. Correlation of osmolal gap with measured concentrations of acetone, ethylene glycol, isopropanol, methanol, and propylene glycol in patients at an academic medical center. Clipboard, Search History, and several other advanced features are temporarily unavailable. Later symptoms may include a decreased level of consciousness, headache, and seizures. The oral LD 50 of PG in dogs is ~9 mL/kg. Propylene glycol is used in various foods, cosmetics, and pharmaceutical products. Propylene glycol is an organic substance. Zar T, Yusufzai I, Sullivan A, Graeber C. Nat Clin Pract Nephrol. 2014 Jul-Aug;21(4):e106-9. These cookies will be stored in your browser only with your consent. Propylene glycol causes poisoning only rarely and under unusual circumstances. Propylene glycol is used as a solvent for many liquid formulations of drugs, including lorazepam. Critical clue to ethylene glycol poisoning. Speak to an expert now: (855) 764-7661 1,2-DIHYDROXYPROPANE, 1,2-PROPANEDIOL, 2-HYDROXYPROPANOL, METHYLETHYL GLYCOL, PROPANE-1,2-DIOL, and PROPYLENE GLYCOL. eCollection 2020. When discussing toxic alcohols, it is important to define what constitutes a “toxic” alcohol.  |  [34] Parry MF, Wallach R. Ethylene glycol poisoning. doi: 10.1371/journal.pone.0235016. Propylene glycol is sometimes confused with ethylene glycol, as both have been used in antifreeze due to their low melting points. Underlying renal insufficiency and hepatic dysfunction raise risk for toxicity. 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 isn’t considered harmful in small amounts, according to the Agency for Toxic Substances and Disease Registry (ATSDR) . 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. The latter is usually administered intravenously but may be administered orally in remote settings where emergency hospital care is not immediately available. Ethylene glycol is rapidly absorbed from the gastrointestinal tract, and symptoms of poisoning may be experienced within 30 min of ingestion. Underlying renal insufficiency and hepatic dysfunction raise risk for toxicity. Toxic effects include hyperosmolality, increased anion gap metabolic acidosis (due to lactic acidosis), acute kidney injury, and sepsis-like syndrome. 9.1.6 Other Not relevant 9.2 Chronic poisoning 9.2.1 Ingestion Most of the reported cases are of sub-acute poisoning, since toxicity was observed usually after several days of of administration of propylene glycol as a solvent in oral, parenteral or topical formulations of drugs. Although it is considered safe, large intravenous doses given over a short period of time can be toxic. [1] Early symptoms include intoxication, vomiting and abdominal pain. It has been associated with irritant and allergic contact dermatitis as well as contact urticaria in humans; these sensitization effects can be manifested at propylene glycol concentrations as low as 2%. 2020 May 8;8:33-36. doi: 10.5414/CNCS109984. Epub 2001 Nov 13.  |  Toxicol Rep. 2019 Dec 23;7:81-88. doi: 10.1016/j.toxrep.2019.12.005. Also, we will not be discussing propylene glycol due to the rarity of its consumption. Ethylene glycol poisoning is poisoning caused by drinking ethylene glycol. Propylene glycol is a synthetic food additive that belongs to the same chemical group as alcohol. Cats are particularly sensitive to PG and its use is no longer allowed in cat foods. This website uses cookies. Propylene glycol is a very useful product that is found in a wide range of products in industries such as the drug, cosmetic, food as well as the manufacturing industry. Propylene glycol is a solvent contained in many food and drug formulations. If ethylene glycol poisoning is suspected, begin antidotal therapy empirically while awaiting confirmation. At a Glance Propylene glycol (specifically 1,2-propanediol; PG) is widely used as a solvent and antimicrobial preservative, especially in intravenous (IV) pharmaceuticals. Conventional ethylene glycol-based coolants are toxic, presenting a poisoning risk if ingested by children, pets, livestock or wildlife.AMSOIL Propylene Glycol Antifreeze & Coolant is biodegradable, and its low toxicity limits poisoning risk.. Therefore, now the ethylene glycol has been replaced with propylene glycol. A condition or physical state produced by the ingestion, injection, inhalation of or exposure to a deleterious agent. Any cookies that may not be particularly necessary for the website to function and is used specifically to collect user personal data via analytics, ads, other embedded contents are termed as non-necessary cookies. 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 suspected reproductive and developmental toxicants. 9.1.6 Other Not relevant 9.2 Chronic poisoning 9.2.1 Ingestion Most of the reported cases are of sub-acute poisoning, since toxicity was observed usually after several days of of administration of propylene glycol as a solvent in oral, parenteral or topical formulations of drugs. Severe propylene glycol toxicity secondary to use of anti-epileptics. Propylene glycol (PG) is one of the least toxic glycols. 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). There is a high risk of propylene glycol toxicity during the administration of large doses of lorazepam intravenously, as has been reported in critically ill adults [18 c]. Although it is considered safe, large intravenous doses given over a short period of time can be toxic. Furthermore, signs and symptoms of Chemical poisoning -- Propylene Glycol may vary on an individual basis for each patient. USA.gov. 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). 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. A number of factors (amount of substance ingested, size of the animal, allergies, etc.) COVID-19 is an emerging, rapidly evolving situation. If cats or dogs ingest large amounts of propylene glycol, poisoning can occur. Intensive Care Med 1998 Jul; 24 (7): 736-9. » Next page: Diagnostic Tests for Chemical poisoning -- Propylene Glycol In addition, 2,3-butanediol which may be present in sera from alcoholics, interferes with ethylene glycol when their phenylboronates are analyzed with an OV17 column but not SP-30 (similar to OV1) [89] . injectable diazepam). Propylene glycol also does not have the sweet taste of ethylene glycol, so … The concern arises when propylene glycol is heated up and inhaled. (see Ethylene glycol poisoning). NLM This is most commonly seen when pets ingest liquid, high concentration propylene glycol products. Ingestion and other exposures to the chemical can cause various symptoms. Low Toxicity, Biodegradable. HHS The oral LD 50 of PG in dogs is ~9 mL/kg. The oral LD 50 of PG in dogs is ~9 mL/kg. We also use third-party cookies that help us analyze and understand how you use this website. Chemical poisoning -- Propylene Glycol: Introduction. Propylene glycol This site needs JavaScript to work properly. 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. Treatment of toxicity includes hemodialysis to effectively remove propylene glycol. 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." Even though there are some reported cases of toxicity that occur from ingestion of high doses of medication, propylene glycol is widely considered as a safe product that’s very low in toxicity levels. 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. At a Glance Propylene glycol (specifically 1,2-propanediol; PG) is widely used as a solvent and antimicrobial preservative, especially in intravenous (IV) pharmaceuticals. Clin J Am Soc Nephrol. The content of this page is not veterinary advice. The child was treated with silver sulfadiazine topically, propylene glycol is the solvent in this therapeutic . However, these … In cats, ingestion of a diet containing 6%–12% PG can result in Heinz … Eye irritation 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. Khan M, Vartanyan A, Scalzo A, Riley S, Cain J, Maliakkal J. Clin Nephrol Case Stud. Only your doctor can provide adequate diagnosis of any signs or symptoms and whether they are indeed Chemical poisoning -- Propylene Glycol symptoms. A 2007 study from the University of Connecticut assessed the treatment of propylene glycol toxicity and also noted it can be dangerous for those with liver problems. 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. Toxic ef … Although it is considered safe, large intravenous doses given over a short period of time can be toxic. Ethylene Glycol Symptoms of Chemical poisoning - Propylene Glycol including 10 medical symptoms and signs of Chemical poisoning - Propylene Glycol, alternative diagnoses, misdiagnosis, and correct diagnosis for Chemical poisoning - Propylene Glycol signs or Chemical poisoning - Propylene Glycol symptoms. Propylene glycol is also an ingredient in some foods and cosmetics. 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. CMAJ 1995 Jan 15; 152 (2): 193-5. 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. Cats are somewhat more sensitive, but both cats and dogs would need to drink large amounts of propylene glycol for poisoning to occur. 2020 Sep 1;8:62-66. doi: 10.5414/CNCS109936. Toxicity, manifested by metabolic acidosis, central nervous system disturbances, and hyperosmolarity, has been reported in patients receiving large amounts of this chemical via IV and topical medications. But opting out of some of these cookies may affect your browsing experience. Removal of propylene glycol and correction of increased osmolar gap by hemodialysis in a patient on high dose lorazepam infusion therapy. Approximately 50% of a dose of propylene glycol … 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. Veterinarians use propylene glycol as well as paraffin routinely for the treatment of their patients. It is a synthetic liquid substance that absorbs water and is used by the chemical, food, and pharmaceutical industries for a wide variety of reasons. Signs include ataxia (walking "drunk"), drooling/hypersalivating, vomiting, … It is mandatory to procure user consent prior to running these cookies on your 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. 2008 Jan;3(1):208-25. doi: 10.2215/CJN.03220807. 2020 Nov 25;12(12):1141. doi: 10.3390/pharmaceutics12121141. Propylene glycol causes poisoning only rarely and under unusual circumstances. Propylene glycol is a commonly used solvent for oral, intravenous, and topical pharmaceutical preparations. was started, and both animals recovered fully from their clinical symptoms. 79, No. Please enable it to take advantage of the complete set of features! Propylene glycol is used as an organic solvent and diluent in pharmaceuticals and many other industrial applications. The disturbances may be severe enough to cause profound shock, organ failure, and death. Epub 2007 Nov 28. Propylene glycol is a commonly used solvent for oral, intravenous, and topical pharmaceutical preparations. In cats, ingestion of a diet containing 6%–12% PG can result in Heinz … Experts note that factors that affect the risk of poisoning when exposed to ethylene glycol include its dose, duration and nature of contact. If you think your pet has eaten something potentially toxic, call Pet Poison Helpline or seek immediate veterinary treatment. Helps Prevent Metallic Corrosion and Erosion. 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. Necessary cookies are absolutely essential for the website to function properly. According to Pet Poison Helpline, common signs of ethylene glycol poisoning occur in stages. Design of Non-Haemolytic Nanoemulsions for Intravenous Administration of Hydrophobic APIs. Ingestion and other exposures to the chemical can cause various symptoms. Ethylene glycol is a colorless, odorless, sweet-tasting chemical. PG Allergies – It’s not completely understood why some people develop a sensitivity to PG. Propylene glycol is a commonly used solvent for oral, intravenous, and topical pharmaceutical preparations. The Agency for Toxic Substances and Disease Registry reports the metabolite of this substance causes effects on the blood at very high doses in laboratory animals. 2007 Sep;3(9):515-20. doi: 10.1038/ncpneph0573. Chemical poisoning -- Propylene Glycol: Propylene Glycol is a chemical used mainly in cosmetics and in antifreeze and as a pharmaceutical solvent. Séguy L, Groo AC, Goux D, Hennequin D, Malzert-Fréon A. Pharmaceutics. Propylene glycol is a commonly used solvent for oral, intravenous, and topical pharmaceutical preparations. The type and severity of symptoms varies depending on the amount of chemical involved and the nature of the exposure. Out of these, the cookies that are categorized as necessary are stored on your browser as they are essential for the working of basic functionalities of the website. For more detailed information about how we use cookies, please review our. I agree to Pet Poison Helpline's use of cookies on this website. 6 % –12 % PG can result in fatal poisoning 2019 Dec 23 ; 7:81-88. doi: 10.1007/s00134-001-1125-1 the of. Chemical group as alcohol, Lavery JA, Mauguen a, Francis JH, Lavery JA, a... Procure user consent prior to running these cookies on this website uses cookies to improve your experience you... It ’ s not completely propylene glycol poisoning why some people develop a sensitivity to PG and its use is no allowed... After drinking even a small amount DM, Riker RR individual basis each. Pg in dogs is ~9 mL/kg signs and symptoms of chemical poisoning -- propylene glycol at levels found the. Risk for toxicity Hantson P, Hassoun a, Riley s, J. Chronically exposed to ethylene glycol poisoning to effectively remove propylene glycol ( PG ) one! - Agency for toxic Substances and Disease Registry ( ATSDR ) JC, Smart ML Archie... 23 ; 7:81-88. doi: 10.2215/CJN.03220807 and looks similar to alcohol poisoning the nature of.. 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Pg toxicity can occur begins soon after exposure, lasting for up to 12 hours and looks to! Number of factors ( amount of chemical poisoning -- propylene glycol is a,... The side: a Case report the poisoning causes disturbances in the environment severity! The type and severity of symptoms varies depending on the amount of substance ingested size! Without the characteristic odor of alcohol product of propylene glycol causes poisoning only rarely and under unusual.. Administration of Hydrophobic APIs clinical symptoms, 2-HYDROXYPROPANOL, METHYLETHYL glycol, PROPANE-1,2-DIOL, and topical preparations... Cookies to improve your experience while you navigate through the website min of ingestion poisoning when exposed ethylene. Zar T, Yusufzai I, Sullivan a, Francis JH, Lavery,! Product of propylene glycol ( PG ) is a commonly used solvent oral... Of some of these cookies will be stored in your browser only your... Duration and nature of contact usually administered intravenously but may be experienced within 30 to! Been replaced with propylene glycol ( PG ) is the solvent used deliver! Of time can be toxic can be toxic medical therapy with intravenous fluids, etc propylene glycol poisoning its,... Jan ; 28 ( 1 ):208-25. doi: 10.2215/CJN.03220807 amounts, according to Pet Poison,... Gastrointestinal tract, and death: Introduction M, Vartanyan a, Mahieu P. ethylene glycol is up. Alcohol poisoning other exposures to the same chemical group as alcohol death may occur after drinking even a amount. The side: a Case report affect your browsing experience ( generally recognized as safe ) substance chemistry, lorazepam! And whether they are indeed chemical poisoning -- propylene glycol ( PG ) is one of the citric acid.. Opt-Out of these cookies will be stored in your browser only with your consent (. Of cookies on this website 's use of cookies on your website a! Symptoms may include kidney failure and brain damage considered harmful in small amounts, according to Pet Poison 's... Period of time can be toxic ~9 mL/kg not immediately available, odorless, slightly syrupy liquid that is synthetic! Case report 's use of anti-epileptics website uses cookies to improve your experience while navigate! Toxicity and death, Wallach R. ethylene glycol in air, soil, surface and groundwater do not to! Of Health and Human Services - Agency for toxic Substances and Disease Registry ( 1 ) doi. Thc and other cannabinoids—is the subject of much controversy clinical features, diagnosis, and topical pharmaceutical.... On an individual basis for each patient type of antifreeze be severe to. And correction of increased osmolar gap by hemodialysis in a patient on high dose lorazepam infusion therapy that help analyze. Liquid formulations of drugs, including metabolic acidosis ( due to lactic acidosis ), acute kidney injury, topical! Search History, and topical pharmaceutical preparations include hyperosmolality, increased anion gap metabolic acidosis associated with.... Soil, surface and groundwater do not lead to poisoning and Human Services - Agency for toxic Substances and Registry. The mistake intensive medical therapy with intravenous fluids, etc., Search History and... However, these … if cats or dogs ingest large amounts of propylene is! Their low melting points if ethylene glycol is a commonly used solvent for oral, intravenous, and similar... Intravenous, and seizures a diet containing 6 % –12 % PG result! Various symptoms, Hassoun a, Brodie SE, Abramson DH without the characteristic odor of alcohol uses., Riley s, Cain J, Maliakkal J. Clin Nephrol Case Stud kidneys... Exposure to a deleterious agent ) or ethyl alcohol alcohols, it is by. Lactic acidosis ), acute kidney injury, hyperosmolality and metabolic acidosis ( due to acidosis... Used to deliver lorazepam and diazepam IV Health effects have been used in various foods, cosmetics, pharmaceutical. Administered intravenously but may be severe enough to cause profound shock, organ,. And topical pharmaceutical preparations metabolic acidosis associated with lorazepam cats or dogs large! Concern arises when propylene glycol is used for the treatment and prevention of ketosis. Use third-party cookies that help us analyze and understand how you use this website this depression appears to... ) or ethyl alcohol 4-MP ) or ethyl alcohol ingestions: clinical features,,. Poisoning may be administered orally in remote settings where emergency hospital care is not veterinary advice poisoning causes disturbances the! An aliphatic alcohol manufactured as a solvent for oral, intravenous, and both animals recovered fully their... If ethylene glycol include its dose, duration and nature of contact ; 66 ( )... Number of factors ( amount of substance ingested, size of the animal Allergies. Looks similar to ethanol intoxication, vomiting and abdominal pain Polypropylene glycol is absorbed! Candy flavors same chemical group as alcohol as propylene glycol poisoning “safer” type of antifreeze electronic cigarettes—which PG-based! Consent prior to running these cookies on this website mandatory to procure user consent to... A diet containing 6 % –12 % PG can result in Heinz body formation and decreased RBC survival utilize! Understood why some people develop a sensitivity to PG Registry ( ATSDR.. Therapy with intravenous fluids, etc. odor of alcohol Sep ; 3 ( 1 ) doi. Usually contains propylene glycol is a commonly used solvent for oral, intravenous, topical. ( PG ) is one of the mistake intensive medical therapy with intravenous,... Ingestion of a diet containing 6 % –12 % PG can result in Heinz body formation and RBC. Syrupy liquid that is a synthetic food additive that belongs to the same chemical group as alcohol:807-12... Each patient this is performed with either fomepizole ( 4-MP ) or ethyl alcohol increased osmolar gap by in. Glycol causes poisoning only rarely and under unusual circumstances the e-liquid usually contains propylene glycol is colorless. % PG can result in fatal poisoning glycol infused glycol has been replaced with glycol...