Intravenous Nitroglycerin Administration and Ethanol
Authors: J. M. OHAR
Journal: Annals of Internal Medicine (1985)

Letters and Corrections1 April 1985Intravenous Nitroglycerin Administration and EthanolJ. M. OHAR, M.D., A. A. FOWLER, M.D., J. B. SELHORST, M.D., F. L. GLAUSER, M.D.J. M. OHAR, M.D.Search for more papers by this author, A. A. FOWLER, M.D.Search for more papers by this author, J. B. SELHORST, M.D.Search for more papers by this author, F. L. GLAUSER, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-102-4-558_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: Two articles (1, 2) have attributed the neurologic complications of intravenous nitroglycerin therapy to thiamine deficiency or alcohol intoxication. The absence of a history of nutritional deprivation leaves the claim of Wernicke's encephalopathy induced by alcoholic diluents suspect (3). We have further cause to doubt this explanation.We have seen a patient who over 6 hours progressively developed headache, vomiting, bradycardia, loss of consciousness to include coma, and asymmetric third cranial nerve palsies during a trial of intravenous nitroglycerin infusion for pulmonary hypertension. We attributed these neurologic abnormalities to increasing intracranial pressure, which is reported in cats,...References1. SHOOKKIRSHENBAUMHUNDLEYSHOREYLAMAS TJRJG. Ethanol intoxication complicating intravenous nitroglycerin therapy. Ann Intern Med. 1984;101:498-9. LinkGoogle Scholar2. SHOREYBHARDWAJLOSCALZO JNJ. Acute Wernicke's encephalopathy after intravenous infusion of high-dose nitroglycerin. Ann Intern Med. 1984; 101:500. LinkGoogle Scholar3. NADEL A. Wernicke's encephalopathy and high-dose nitroglycerin [Letter]. Ann Intern Med. 1985;102:134. LinkGoogle Scholar4. GHANISUNGWEINSTEINTINDALLFLEISCHER GYMGA. Effects of intravenous nitroglycerin on the intracranial pressure and volume pressure response. J Neurosurg. 1983;58:562-5. CrossrefMedlineGoogle Scholar5. COTTRELLGUPTARAPPAPORTTURNDORFRANSOHOFFFLAMM JBHHJE. Intracranial pressure during nitroglycerin-induced hypotension. J Neurosurg. 1980;53:309-11. CrossrefMedlineGoogle Scholar6. GAGNONMARSHSMITHSHAPIRO RMRH. Intracranial hypertension caused by nitroglycerin. Anesthesiology. 1979;51:86-7. CrossrefMedlineGoogle Scholar1. SHOOKKIRSHENBAUMHUNDLEYSHOREYLAMAS TJRJG. Ethanol intoxication complicating intravenous nitroglycerin therapy. Ann Intern Med. 1984;101:498-9. LinkGoogle Scholar2. BECKER C. The alcoholic patient as a toxicologic emergency. In: HADDAD LM, WINCHESTER JF, eds. Clinical Management of Poisoning and Drug Overdose. Philadelphia: W.B. Saunders Co.; 1983: 389-92. Google Scholar3. BOYDOLIN JB, eds. Drug Facts and Comparisons. St. Louis: J.B. Lippincott Co.; 1984: 143d. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: J. M. OHAR, M.D.; A. A. FOWLER, M.D.; J. B. SELHORST, M.D.; F. L. GLAUSER, M.D.Affiliations: Medical College of Virginia Virginia Commonwealth University Richmond, VA 23298 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byPropylene Glycol Toxicity Following Continuous Etomidate Infusion For The Control Of Refractory Cerebral EdemaPropylene Glycol Toxicity Following Continuous Etomidate Infusion For The Control Of Refractory Cerebral EdemaPropylene glycol-induced side effects during intravenous nitroglycerin therapy 1 April 1985Volume 102, Issue 4Page: 558-559KeywordsCranial nervesEthanolHeadachesIntoxicationLoss of consciousnessNutritionParalysisPulmonary hypertensionThiamineVomiting ePublished: 1 December 2008 Issue Published: 1 April 1985 PDF downloadLoading ...