Sorted By Test Name - Mayo Medical Laboratories

VLTB
89190
the single most important substance of abuse in the United States. It is the active agent in beer, wine,
vodka, whiskey, rum, and other liquors. Ethanol acts on cerebral function as a depressant similar to
general anesthetics. This depression causes most of the typical symptoms of intoxication including
impaired thought, clouded judgment, and changed behavior. As the level of alcohol increases, the degree
of impairment becomes progressively increased. Ethylene Glycol: Ethylene glycol is the active ingredient
in automobile antifreeze which is sometimes consumed as a substitute for ethanol since in the early stages
the inebriating effects of the 2 chemicals are similar. It is converted to several toxic, acidic metabolites
including oxalic acid, which precipitates as calcium oxalate crystals in the kidney, identifiable as such in
the urine. Toxic manifestations include central nervous system depression, nausea and vomiting, muscle
paralysis, ataxia, renal failure, congestive heart failure, pulmonary edema, convulsions, and coma. Other
findings included pronounced metabolic acidosis with large anion gap and Kussmaul respirations,
osmolar gap, and hypocalcemia. 4-Methylpyrazole is the antidote of choice; however, ethanol
administered in 10% concentration of D5W may also be used as an antidote. Both antidotes inhibit
conversion of the relatively nontoxic ethylene glycol to its toxic metabolites.
Useful For: Detection and quantitation of acetone, methanol, isopropanol, and ethanol in serum
Confirming and monitoring ethylene glycol toxicity
Interpretation: Volatiles: Toxic concentrations: Methanol: > or =10 mg/dL Isopropanol: > or =10
mg/dL Acetone: > or =10 mg/dL Ethanol: > or =400 mg/dL Ethylene Glycol: Toxic concentration: > or
=20 mg/dL
Reference Values:
ETHYLENE GLYCOL
Toxic concentration: > or =20 mg/dL
ETHANOL
None detected (cutoff concentration: 10 mg/dL)
Toxic concentration: > or =400 mg/dL
METHANOL
None detected (cutoff concentration: 10 mg/dL)
Toxic concentration: > or =10 mg/dL
Positive results are quantitated.
ACETONE
None detected (cutoff concentration: 10 mg/dL)
Toxic concentration: > or =10 mg/dL
ISOPROPANOL
None detected (cutoff concentration: 10 mg/dL)
Toxic concentration: > or =10 mg/dL
Clinical References: 1. Levine B: Principles of Forensic Toxicology. AACC Press, 1999 2. Tietz
NW: Clinical Guide to Laboratory Tests. 2nd edition. Philadelphia, WB Saunders Company, 1990, pp
208-209
Volatile Screen, Blood
Clinical Information: Volatile substances in the blood include ethanol, methanol, isopropanol, and
acetone. Acetone is generally elevated in metabolic conditions such as diabetic ketoacidosis. Methanol
and isopropanol are highly toxic and result from exogenous ingestion. Ethanol is the single most
important substance of abuse in the United States. It is the active agent in beer, wine, vodka, whiskey,
rum, and other liquors. Ethanol acts on cerebral function as a depressant similar to general anesthetics.
This depression causes most of the typical symptoms such as impaired thought, clouded judgment, and
changed behavior. As the level of alcohol increases, the degree of impairment progressively increases. In
most jurisdictions in the United States, the per se blood level for being under the influence of alcohol
(ethanol) for purposes of driving a motor vehicle is 80 mg/dL.
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