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Intoxication with Fireball Whiskey causing severe lactic acidosis
Moeed Ahmed1, Sunil K Jagadesh1, Mohamad Ali Alhajhusain1
1Creighton University School of Medicine, Omaha, Nebraska.
Proceedings (Baylor University. Medical Center)
|July 5, 2021
Summary
Propylene glycol, used in medications and Fireball Whiskey, can cause severe lactic acidosis. This occurs with unintentional overdosing of medications or excessive alcohol consumption, leading to metabolic acidosis and high osmolal gap.
Area of Science:
- Toxicology
- Pharmacology
- Internal Medicine
Background:
- Propylene glycol is a common excipient in pharmaceuticals and a food additive, generally considered safe.
- It is a diluent in intravenous medications like lorazepam and diazepam.
- Reports exist linking propylene glycol overdose to severe lactic acidosis.
Observation:
- Two cases of severe lactic acidosis were observed.
- These cases were associated with the consumption of Fireball Whiskey.
- Patients presented with metabolic acidosis and elevated osmolal gap.
Findings:
- Propylene glycol toxicity can manifest as severe metabolic acidosis.
- Elevated osmolal gap is a key laboratory finding in propylene glycol poisoning.
- Consumption of alcohol containing propylene glycol can lead to toxic levels.
Implications:
- Healthcare providers should consider propylene glycol toxicity in patients with unexplained metabolic acidosis.
- Awareness of propylene glycol as a potential toxic agent in alcoholic beverages is crucial.
- Further research into safe consumption limits of propylene glycol in food and beverages is warranted.
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