A 53-year-old woman with a suspected drug overdose

The immediate priority in the management of In toxic alcohol ingestion, the parent alcohol contributes to suspected toxic alcohol exposure is the administration of an anti- the osmole gap, and is metabolized by alcohol dehydrogenase, dote. [...] The parent alcohol contributes to the osmole gap and is metabolized by alcohol dehydrogenase (ADH) and then aldehyde dehydrogenase to produce acid metabolites that contribute to the anion gap. [...] Derivation and validation of a formula to cal- culate the contribution of ethanol to the osmolal gap. [...] agement until the results of definitive tests are available.1,5 Contributors: All of the authors contributed to the conception and Propylene glycol is a diluent alcohol in many pharmaceut- design of the work, drafted the manuscript, revised it critically for icals, foods and cosmetics.12 The presentation of propylene gly- important intellectual content, gave final approval of the version to be pub. [...] The answer and a brief discussion of the condi- fluids, she recovered a normal level of consciousness, and she tion follow.