Aldehyde and divalent glycols

Question 1

Different aldehydes

Answer 1

• Formaldehyde (CHOH)
• Acetaldehyde (CH₃COH)
• Metaldehyde (CH₃COH)

Question 2

Formaldehyde intoxication effects? Contraindications?

Answer 2

Effects:

• Protein precipitation ==> necrotic effect
• Symptoms similar to acid poisoning

Contraindications:

• Don’t give sulfonamides ==> formation of insoluble compouds which precipitates in the kidney tubuli ==> anuria, uremia

Question 3

Formaldehyde intoxication therapy?

Answer 3

• Milk, water
• Gastric lavage
• Alkalization
• Hemodialysis

Question 4

Acetaldehydes intoxication effects?

Answer 4

• Local irritating effect
• Central narcotic effect

Question 5

Metaldehyde toxicity?

Answer 5

It is very toxic:

• Lethal dose for adults: 4g
• Lethal dose for children: 0.1-0,5g

Question 6

Metaldehyde symptoms?

Answer 6

• GIT reaction:
  
  • ​Local irritation
  • Hemorrhagic gastritis
• Central effects:
  
  • ​Increased muscle irritability
  • Muscle rigidity
  • Epileptiform seizures
  • Stop of respiration

Question 7

Metaldehyde therapy?

Answer 7

• Gastric lavage
• Induction of emesis
• Activated charcoal
• Purgation
• Symptomatic treatment

Question 8

Source of divalent glycoles?

Answer 8

• Solvents
• Lubricants
• Anti-freeze susbtance

They solve both hydro- and lipophilic substances

Question 9

Which are the divalent glycols?

Answer 9

• Diethylene glycol
• Ethylene glycol

Question 10

Pathogenesis of divalent glycols?

Answer 10

Question 11

Divalent glycols intoxication symptoms?

Answer 11

• Transient excitation –> depression (at the beginning)
• Changes of water and osmotic balance, metabolic acidosis (strong water suction effect)
• Hepatic failure
• Irritation of alveoli (if inhaled)

Question 12

Divalent glycols intoxication therapy?

Answer 12

No specific antidote!

• Early, ethanol or fomepizole infusion –> alcohol dehydrogenase inhibition
• In case of muscle spasm: Calcium IV