concentrations, the longer the elimination process because the capacity of the body to produce alcohol dehydrogenase is limited The rate of reduction in blood alcohol concentration varies from 10 to 25 mg/dL/hr Although hemodialysis effectively enhances elimination by three- to fourfold, it is rarely necessary The institution of hemodialysis may be useful in those patients who have impaired liver function or a blood alcohol concentration higher than 450 to 500 mg/dL Isopropyl Alcohol Poisoning with isopropyl alcohol may be particularly insidious because oral ingestion is not the only route of exposure Children may develop severe intoxication, including coma, after topical application of isopropyl alcohol for the relief of fever (although such exposure may represent inhalational exposure rather than direct, dermal absorption) Because isopropyl alcohol is usually available in a 70% concentration by volume, ingestion of to 2.5 mL/kg of this solution may lead to symptoms Ingestion causes many of the same features as ethanol ingestion, with the additional complication of severe gastritis Unlike the other toxic alcohols, isopropyl alcohol does not lead to metabolic acidosis This is because its metabolite, acetone, is not an acid However, it is approximately twice as intoxicating as ethanol, leading to greater mental status impairment at comparable serum levels At high serum levels, isopropyl alcohol causes direct myocardial depression, which may be life threatening