38(7), minutes her pH the patient’s as headache, (2000) dropped to 7.03. clinical status, nausea, and haemodialysis dizziness was was initiated not reported. but Overall, discontinued fomepizole temporarily due appeared safe to catheter in this patient thrombus although she formation. The developed initial (3-hour transient post-admission) nystagmus. EG was 13 mg/dL. EG was 5 mg/dL 3 hours after haemodialysis this then was discontinued. No further fomepizole was administered 3 Boyer, 2001. 13-year-old female Ethanol was Discharged Authors EG ingested approx. 4 given at primary 3 days suggest that ‘Severe ingestion fluid ounces of hospital; Six hrs with no use of treated antifreeze after EG sequelae. At fomepizole without BUN=11.0 mg/dL, ingestion she discharge on averted IV creatinine 0.8 received the third ethanol mg/dL, and glucose fomepizole 15 hospital day, infusion & 105 mg/dL. Anion mg/kg IV she had BUN= Pediatrics gap was 14 mg/dL. loading dose. 10 mg/ml & limited the 2001;107;172 An arterial blood Arterial pH serum duration of gas showed pH 7.38, remained above creatinine = intensive care osmolar gap of 53 7.35. 0.6 mg/mL monitoring & mosM/L. The fomepizole, 10 decreased measured serum EG mg/kg, was overall cost of was 103 mg/dL. given every 12 treatment. hrs for total of 5 However, doses. Serum EG important to was after 23 note that mg/mL after patient had 24hrs after normal renal ingestion, function at 13mg/ml by 36 admission. hrs. 4 Detaille, 2004. 5-month old boy Antidotal The infant Although not ingested 200ml of therapy with a made a yet approved ‘Fomepizole alone for antifreeze solution. total of seven complete for this severe infant Presented with doses of recovery with indication in EG poisoning.’ metabolic acidosis- fomepizole no change in the child, Pediatr Crit given IV with an renal function. fomepizole
38(7), (2000) minutes her pH dropped to 7.03. the patient’s clinical status, haemodialysis was initiated but discontinued temporarily due to catheter thrombus formation. The initial (3-hour post-admission) EG was 13 mg/dL. EG was 5 mg/dL 3 hours after haemodialysis this then was discontinued. No further fomepizole was administered as headache, nausea, and dizziness was not reported. Overall, fomepizole appeared safe in this patient although she developed transient nystagmus. 3 Boyer, 2001. ‘Severe EG ingestion treated without Pediatrics 2001;107;172 13-year-old female ingested approx. 4 fluid ounces of antifreeze BUN=11.0 mg/dL, creatinine 0.8 mg/dL, and glucose 105 mg/dL. Anion gap was 14 mg/dL. An arterial blood gas showed pH 7.38, osmolar gap of 53 mosM/L. The measured serum EG was 103 mg/dL. Ethanol was given at primary hospital; Six hrs after EG ingestion she received fomepizole 15 mg/kg IV loading dose. Arterial pH remained above 7.35. fomepizole, 10 mg/kg, was given every 12 hrs for total of 5 doses. Serum EG was after 23 mg/mL after 24hrs after ingestion, 13mg/ml by 36 hrs. Discharged 3 days with no sequelae. At discharge on the third hospital day, she had BUN= 10 mg/ml & serum creatinine = 0.6 mg/mL Authors suggest that use of fomepizole averted IV ethanol infusion & limited the duration of intensive care monitoring & decreased overall cost of treatment. However, important to note that patient had normal renal function at admission. 4 Detaille, 2004. ‘Fomepizole alone for severe infant EG poisoning.’ Pediatr Crit 5-month old boy ingested 200ml of antifreeze solution. Presented with metabolic acidosis- Antidotal therapy with a total of seven doses of fomepizole given IV with an The infant made a complete recovery with no change in renal function. Although not yet approved for this indication in the child, fomepizole
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