Elimination
- 80% excreted unchanged through the lungs.
- 3% in Urine
It is metabolized and excreted at a rate approximately 1/5th of that of ethyl alcohol. After a single dose, the excretion may continue through the lungs and kidneys for at least four days.
Laboratory Findings
- Severe metabolic acidosis
- Moderate ketonemia
- Acetonuria
- Strongly acidic urine – containing albumin, acetone and formic acid
- Increased serum amylase – but this hyperamylasemia even when striking, should not be equated with pancreatitis because it is found to be mostly due to salivary type amylase.
Thus, many specific laboratory tests for pancreatitis should be used before embarking on extensive investigations of the pancreas.
Initially, optic disc hyperaemia and peripappilary edema. When symptoms persist and scotomas or complete blindness develops, there is optic disc pallor and attenuation of arterioles.
Decreased pupillary response which has prognostic significance.
Treatment
- First with plain water – to be preserved for chemical analysis
- Subsequently, with 4% NaHCO3 solution in warm water
- 500cc of this solution should be left in the stomach at the end.
Diuresis
Sodium lactate and 5% glucose saline by intravenous drip to help in diuresis.
Correction of Acidosis
It is the main stay of the treatment.
Soda–bi–carb by mouth – 1–2 gm/15 min in 200 ml water. if the patient is unconcious, by stomach tube. The dose may be repeated 3–4 times keeping a to see that the plasma bicarbonate level is kept at about 20 mg/litre. Urinary reaction may be used as a guide towards administration of alkali. Oral treatment is not possible.
