The treatment of ethylene glycol toxicosis with pyrazole

Rats and dogs were protected from the effects of lethal doses of ingested ethylene glycol (EG) with pyrazole (P), an inhibitor of liver alcohol dehydrogenase. Rats given 1.35 ml/100 g of EG followed by 2.2 mmol/kg of P i.p. at 6 and 30 hours postingestion survived. Untreated control animals died. Dogs were given either 10.0 or 12.5 ml/kg of EG and treatment was begun 6 hours later. The control treatment consised of NaHC03 administered i.v. according to the calculated base deficit, B-complex vitamins with ascorbic acid, hydrocortisone, and 5 per cent glucose in water. The addition postexposure to this treatment of 0.9 mmol/kg of P and 0.5 mmol/kg of P at 6 and 30 hours, respectively, constituted the experimental therapy. In summary: with 10 ml/kg of EG, no P, 2 of 5 dogs survived; 12.5 ml/kg of EG, no P, 0/1; 10 ml/kg of EG plus P, 9/11; 12.5 ml/kg of EG plus P, 12/22. Dogs that succumbed had large numbers of oxalate crystals in their kidneys at necropsy. The surviving dogs had few oxalate crystals in their kidneys at the time of unilateral nephrectomy (2 weeks postexposure) or necropsy (30 days postexposure). Several clinical factors were identified as useful prognostic indicators in the treatment of EG poisoning. The results suggested that pyrazole, despite its marked toxicity, may be of clinically significant value in the treatment of ethylene glycol poisoning when therapy is initiated withing 6 hours of exposure.