Source: Medicines & Healthcare Products Regulatory Agency (GB) Revision Year: 2008 Publisher: Macarthys Laboratories Limited, T/A Martindale Pharmaceuticals, Bampton Road, Harold Hill, Romford, RM3 8UG
Severe and chronic pain including that caused by trigeminal neuralgia may be relieved by injection of alcohol close to the nerve.
Alcohol is given intravenously in the treatment of acute poisoning from methanol.
0.2ml, for a small nerve root to a maximum of 10ml for blockade of the coeliac ganglion. Injected into the individual nerve root or ganglion. The needle tip should ideally be located by radiographic or fluoroscopic means prior to dose delivery.
A loading dose of 600–800mg/kg should be given. If used parenterally this should be in the form of 7.5ml/kg of a 10% infusion of Ethanol in 5% Glucose Solution for Infusion. The infusion should be given over 30minutes preferably via a central venous catheter.
The standard maintenance dose, for an average patient is 120-138mg of 100% ethanol/kg/hr (1.38ml of 10% ethanol/kg/hr) by the IV route.
Blood monitoring should occur every 1-2hours until a concentration of 1-1.5g/L is reached and thereafter at 2-4hourly intervals. After the loading dose maintenance concentrations should be reduced dependant on the normal drinking habits of the patient and any other concomitant treatments.
Patients treated with Ethanol require close monitoring preferably in a critical care area because of the risk of CNS and respiratory depression.
| Amount Absolute (100%) Ethanol | Volume 5% Ethanol by IV Injection | Volume 10% Ethanol by IV Injection | |
|---|---|---|---|
| Loading Dose Over 30 minutes | 600-800mg/kg | 15ml/kg | 7.5ml/kg |
| Standard maintenance dose (non-drinker/child) | 80-83 mg/kg/hr | 1.66ml/kg/hr | 0.83ml/kg/hr |
| Standard maintenance dose (average adult) | 120-138 mg/kg/hr | 2.76/ml/kg/hr | 1.38ml/kg/hr |
| Standard maintenance dose (drinker) | 184-196 mg/kg/hr | 3.92ml/kg/hr | 1.96ml/kg/hr |
| Maintenance dose during dialysis (non-drinker/child) | 200-213 mg/kg/hr | 4.26ml/kg/hr | 2.13ml/kg/hr |
| Maintenance dose during dialysis (average adult) | 240-268 mg/kg/hr | 5.36ml/kg/hr | 2.68ml/kg/hr |
| Maintenance dose during dialysis (drinker) | 308-326 mg/kg/hr | 6.52ml/kg/hr | 3.26ml/kg/hr |
Ethanol can be added to peritoneal dialysate at a concentration of 1-2g/L of dialysate.
Acute toxicity is primarily one of CNS depression.
In acute poisoning the stomach may be emptied by aspiration and lavage if indicated. If respiration is depressed, assisted respiration may be necessary. It is important to provide good supportive treatment and to keep the patient warm. Fluid balance should be maintained by the use of suitable electrolyte solution, and glucose may be needed for the treatment of hypoglycaemia.
Shelf life: 60 months (unopened).
None stated.
Colourless ampoules of neutral glass packed into cartons of 10 ampoules, containing 2ml, 5ml, 10ml, 20ml, or 50ml of solution.
None stated.
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