Friday August 29, 2008
Propylene Glycol

Being an intensivist it is imperative to understand the dangers of propylene glycol in ICU particularly with Lorazepam drip. Risks are too high if drip is continued beyond 48 hours and dose more than 10 mg/hr. Any unexplained high anion gap metabolic acidosis with elevated osmol gap, should prompt the diagnosis of propylene gylcol toxicity. It may also cause CNS depression, arrhythmias and renal dysfuntion.

Propylene glycol is a viscous, colorless liquid solvent used for many drugs with poor aqueous solubility including lorazepoam, diazepam, esmolol, nitroglycerin, pentobarbital, phenytoin, trimethoprim/sulfamethoxazole and others.