Toluene Toxicity Medication

  • Author: Nathanael J McKeown, DO; Chief Editor: Asim Tarabar, MD   more...
 
Updated: Apr 11, 2011
 

Medication Summary

No specific antidotal drug therapy for toluene poisoning exists. Toluene is not significantly adsorbed by activated charcoal.

Presently, inhaled beta-agonists and steroid therapy should be considered first-line agents for patients presenting with asthma and respiratory symptoms.

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Cardiovascular Agent

Class Summary

These agents may be used to convert an inhalant-induced dysrhythmia.

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Esmolol

 

Ultra–short-acting agent that selectively blocks beta1-receptors with little or no effect on beta2-receptor types. Particularly useful in patients with elevated arterial pressure, especially if surgery is planned. Shown to reduce episodes of chest pain and clinical cardiac events compared to placebo. Can be discontinued abruptly if necessary. Useful in patients at risk for experiencing complications from beta-blockade; particularly those with reactive airway disease, mild-moderate LV dysfunction, and/or peripheral vascular disease. Short half-life of 8 min allows for titration to desired effect and quick discontinuation if needed.

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Propranolol

 

Class II antiarrhythmic, nonselective, beta-adrenergic, receptor blocker with membrane-stabilizing activity that decreases automaticity of contractions.

Effective for treating aggression resulting from head injury. They also are used for reducing restlessness and disinhibition. Treatment for persistent agitation and aggression in organic brain syndromes.

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Alkalinizing agents

Class Summary

These agents may be used to raise blood and urinary pH.

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Sodium bicarbonate (Neut)

 

Neutralizes hydrogen ion concentrations and raises blood and urinary pH. Drip can be prepared with 2-3 ampules of bicarbonate in 1 L of D5W, run at 50-200 mL/h, with pH followed to maintain range of 7.45-7.55; alternatively, monitor patient and administer boluses of bicarbonate prn if QRS widening and block resolves with initial treatment

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Contributor Information and Disclosures
Author

Nathanael J McKeown, DO  Assistant Professor, Oregon Health and Science University; Medical Toxicologist, Oregon Poison Center; Attending Physician, Emergency Medicine, Portland Veteran Affairs Medical Center, Oregon Health and Science University

Nathanael J McKeown, DO is a member of the following medical societies: American Academy of Clinical Toxicology, American College of Emergency Physicians, American College of Medical Toxicology, Society for Academic Emergency Medicine, and Wilderness Medical Society

Disclosure: Nothing to disclose.

Specialty Editor Board

Debra Slapper, MD  Consulting Staff, Department of Emergency Medicine, St Anthony's Hospital

Debra Slapper, MD is a member of the following medical societies: American Academy of Emergency Medicine

Disclosure: Nothing to disclose.

John T VanDeVoort, PharmD  Regional Director of Pharmacy, Sacred Heart and St Joseph's Hospitals

John T VanDeVoort, PharmD is a member of the following medical societies: American Society of Health-System Pharmacists

Disclosure: Nothing to disclose.

Fred Harchelroad, MD, FACMT, FAAEM, FACEP  Director of Medical Toxicology, Allegheny General Hospital

Disclosure: Nothing to disclose.

John D Halamka, MD, MS  Associate Professor of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center; Chief Information Officer, CareGroup Healthcare System and Harvard Medical School; Attending Physician, Division of Emergency Medicine, Beth Israel Deaconess Medical Center

John D Halamka, MD, MS is a member of the following medical societies: American College of Emergency Physicians, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Chief Editor

Asim Tarabar, MD  Assistant Professor, Director, Medical Toxicology, Department of Emergency Medicine, Yale University School of Medicine; Consulting Staff, Department of Emergency Medicine, Yale-New Haven Hospital

Disclosure: Nothing to disclose.

Additional Contributors

The authors and editors of eMedicine gratefully acknowledge the contributions of previous author, Kevin A Martin, MD, to the development and writing of this article.

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