Substance
Benzyl Alcohol (C₇H₈O) - A preservative
used in medications, cosmetics, and industrial applications. Metabolized in the
liver to benzoic acid and hippuric acid, which are eliminated by the kidneys [1].
Common Name
Benzyl Alcohol
Found in solution in 注射劑的防腐劑， 照相顯影劑， 墨水、塗料、油漆、環氧樹脂塗料、染料、
明膠等的溶劑， 也用於製取香料和調味劑, 以作為肥皂、香水、化妝品和其他產品中的添加劑.
Involving System
Central Nervous System (CNS): Sedation,
lethargy, coma, seizures
Cardiovascular System: Hypotension [2], tachycardia, cardiac collapse Metabolic System:
Metabolic acidosis (high anion gap)
Respiratory System: Respiratory depression,
Respiratory depression [3].
Moderate poisoning: Severe drowsiness, hypotension, metabolic
acidosis
- Severe poisoning: Coma, seizures, respiratory failure,
cardiovascular collapse
Examination & Diagnosis
- Blood gas analysis: Metabolic acidosis
with increased anion gap - Serum benzyl alcohol or benzoic acid levels (if
available)
- Electrolytes, lactate, and kidney
function tests
- ECG: Arrhythmia evaluation
- Chest X-ray: If respiratory complications
are suspected
Presentation [4].
Mechanism & Metabolism (M)
Overdose leads to CNS depression, metabolic
acidosis, and respiratory failure due to toxic metabolites.
AMS: altered mental status
Acidosis: metabolic acidosis
Hypokalemia, hypophosphatemia
Hyperammonemia.
Neonates are particularly vulnerable due to
immature liver metabolism.
Antidote
Decontamination & Initial Management
-
Activated charcoal is generally not recommended unless ingestion is recent and
in large amounts
- Supportive care is key (IV fluids, oxygen
therapy)
Pharmacological Treatment
- Sodium bicarbonate IV to correct
metabolic acidosis
- Hemodialysis in severe cases with renal
failure or refractory acidosis
- Symptomatic treatment: Vasopressors for
hypotension, anticonvulsants for seizures
Disposition
Clinical Disposition & Follow-up
- Mild cases: Observation for 6–12 hours
with supportive care
- Moderate to severe cases: ICU admission
for ventilatory support and hemodynamic monitoring
- Neonatal cases: Extreme caution, as even
small amounts can cause fatal "gasping syndrome" due to toxic
accumulation. [5].
Hemodialysis Indications: Severe metabolic
acidosis, renal impairment, or refractory symptoms.
References
[1]. https://pubmed.ncbi.nlm.nih.gov/3229281/
[2]. https://pubmed.ncbi.nlm.nih.gov/2922508/
[3]. https://pubmed.ncbi.nlm.nih.gov/35787785/
[4]. https://pubmed.ncbi.nlm.nih.gov/35466010/
[5]. https://pubmed.ncbi.nlm.nih.gov/7133084/