Substance
去光水的主要成分是揮發性有機溶劑，最常見的丙酮(Acetone) 和 甲苯(Toluene)，用於溶解指甲油中的高分子聚合物。 市面上也有較溫和的無丙酮去光水，可能含有乙醇(Ethanol)、醋酸乙酯(Ethyl Acetate)、異丙醇(Isopropyl Alcohol) , 醋酸丁酯 (Butyl acetate)或是添加大豆油酸甲酯等滋潤成分。 選擇時應注意標示，避免含有禁用的甲醇，並在通風處使用。 常用成分
丙酮(Acetone): 最常見的溶劑，溶解力強，但也容易使指甲乾燥、脆弱。
甲苯(Toluene): 也是常用成分，具有揮發性，但對健康影響較大。
醋酸乙酯(Ethyl Acetate): 另一種常見的有機溶劑。
異丙醇(Isopropyl Alcohol): 常用於無丙酮配方中。
Common name
去光水、卸甲液、洗甲水、除甲水。
英文名：Nail Polish Remover。[1] CH3COCH3 [2]
Involving systems
Acetone: metabolism of acetone is independent of the
route of absorption and occurs primarily in the liver [1] excreted
through the lung and a little through the urine irrespective of the route of
exposure, and elimination is usually completed within 48-72 hours after
exposure.
Central Nervous System (CNS): Primary
target system. [3, 4]
Respiratory System: Mucous membrane
irritation and potential respiratory depression.[3,
4]
Gastrointestinal (GI) System: Direct
mucosal irritation. Vomiting, abdominal pain and gastrointestinal bleeding.[1]
Cardiovascular System: Potential for hypotension
and tachycardia.[1]
Dermal/Ocular: Local irritant effects.[4]
Presentation
CNS Effects
(Dose-dependent) [3]
- Feeling
of inebriation or drunkenness.
- Headache,
dizziness, and lethargy.
- Confusion,
drowsiness, and ataxia (lack of coordination).
- Severe
Cases:
Stupor, coma, and respiratory arrest.
Respiratory Effects [3]
- Irritation of the nose, throat, and lungs. Bronchial edema [1]
- Coughing
and dyspnea (shortness of breath).
- Hypoventilation
(decreased respiratory rate).
- Risk of
aspiration pneumonitis if vomiting occurs.
GI Effects [1]
- Nausea
and vomiting.
- Abdominal
pain.
- Sweet,
fruity odor on the breath (characteristic of acetone).
- Hypotension (low blood pressure).[1]
- Tachycardia (fast heart rate).[1]
Local Effects (Skin/Eyes)
- Ocular: Eye irritation, pain, redness, and tearing.
Corneal injury [4]
- Dermal: Skin drying, cracking, and
redness upon prolonged contact.
Antidote and Management
- Supportive
Care is Paramount: Focus
on Airway, Breathing, and Circulation (ABC). [1]
- Airway and Breathing: [1]
- Monitor
oxygen saturation and respiratory function closely.
- Administer
supplemental oxygen as needed.
- Intubation
and mechanical ventilation may be required for severe respiratory
depression or failure.
- Circulation:
- Establish
intravenous access (IV access).[1]
- Administer
IV fluids to manage hypotension.
- Monitor
ECG.
- Decontamination
(Ingestion):
- DO NOT
induce vomiting (risk
of aspiration).
- Gastric
lavage is generally discouraged and rarely necessary, but may be
considered for massive ingestion if performed early and with a protected
airway.
- Activated
charcoal is ineffective against acetone.
- Specific
Monitoring:
- Monitor
acetone and serum ketone levels.
- Monitor
fluid and electrolyte status.
- No
Specific Antidote Exists.
Disposition
- Mild to
Moderate Exposure:
Patients typically recover completely within hours to days, as acetone is
relatively quickly metabolized and excreted.
- Severe
Intoxication:
Prognosis depends on the severity and duration of CNS and respiratory
depression.
- Patients
surviving the initial 48 hours generally have a favorable outcome.
- Death
is rare but can occur due to profound respiratory failure or aspiration
pneumonitis.
For blood acetone levels of 20-30
mg/dl (severe intoxication), symptoms such as somnolence (drowsiness), ataxia
(lack of coordination), slurred speech, and potentially deep coma may occur. A
blood level of 55 mg/dl or higher is often considered the fatal level, based on
concentrations detected in documented fatal poisoning cases. [1]
LD50: oral LD50 value of 3,687 mg/kg was found for
male guinea pigs (Strieger and Carpenter 1961). [4]
- Discharge
Criteria:
Patients can typically be discharged once symptoms (especially CNS
depression) have fully resolved and they are observed for a period of 4–6
hours post-exposure (depending on the dose and route).
References
1.
https://pubmed.ncbi.nlm.nih.gov/34754632/,
2.
https://www.ncbi.nlm.nih.gov/books/NBK208291/
3.
https://pubmed.ncbi.nlm.nih.gov/3362729/
4.
https://www.ncbi.nlm.nih.gov/books/NBK590392/
