diethylene glycol dangers

It was not until September 1996 that Sinochem provided a name of the manufacturer of the tainted syrup. Because of its toxicity, it’s not allowed in food or drugs. Diethylene Glycol Poisoning. Join our newsletter to stay up to date on dangerous drugs and devices, keep up on lawsuit and settlement news, learn about FDA recalls, and more. 77, No. Industry Circular No. It’s a solvent for water-insoluble drugs and chemicals, and it’s used to make products such as cigarettes, antifreeze, lubricants, brake fluids, cosmetics and wallpaper strippers. Patients were treated with fluid hydration and correction of acidosis, but some were not able to survive. [2] It can be a contaminant in consumer products; this has resulted in numerous epidemics of poisoning since the early 20th century. These measures quickly ended the advance of the epidemic. DEG poisoning has three characteristic phases. Some wines contained less than 10 parts per million of DEG, a small amount that could not be detected by laboratory analysis in Europe. Postmortem examination revealed damage in the kidneys and liver, and laboratory testing found DEG instead of propylene glycol in the sedatives. Other than Diethylene Glycol, e-cigarettes also contain cancer-causing compounds like nitrosamines. Diethylene glycol, or DEG, is a chemical that can cause potentially fatal kidney and neurological toxicity. If people don’t get treatment, symptoms progress to multi-organ failure in two to seven days, according to an article by William M. Snellings and colleagues in Regulatory Toxicology and Pharmacology. The toothpaste was labeled as “Manufactured in South Africa” and contained misspellings like "isclinically", "SOUTH AFRLCA" and "South African Dental Assoxiation". Diethylene glycol dinitrate appears as a liquid. The prognosis depends on prompt diagnosis and treatment due to the high mortality rate DEG intoxication produces. Any unauthorized or illegal use, copying or dissemination will be prosecuted. At the request of the United States, the State Food and Drug Administration of China investigated Taixing Glycerine Factory and CNSC Fortune Way, but the agency concluded it is not under their jurisdiction because the factory is not certified to make medicine. ALERT: Your health is top priority. [29] The United States Food and Drug Administration also issued an Industry Guidance Document “intended to alert pharmaceutical manufacturers, pharmacy compounders, repackers, and suppliers to the potential public health hazard of glycerin contaminated with diethylene glycol (DEG)” and recommended appropriate testing procedures for the use of glycerin. 86-13. Diethylene glycol is used in the manufacture of saturated and unsaturated polyester resins, polyurethanes, and plasticizers. Intense Abdominal Pain 5. Find patient medical information for Diethylene Glycol Monoethyl Ether on WebMD including its uses, side effects and safety, interactions, pictures, warnings and user ratings. It can also serve as a dispersant in organosols and can also be used in preparation of plasticizers. Diethylene Glycol Safety Data Sheet according to Federal Register / Vol. [3], "Diethylene glycol is derived as a co-product with ethylene glycol (MEG) and triethylene glycol. However, as required by the new California Consumer Privacy Act (CCPA), you may record your preference to view or remove your personal information by completing the form below. In fact, the company bought the product in China and had already re-exported toothpaste to Costa Rica, Dominican Republic and Haiti, making Panama kick off a local warning. The children later developed kidney failure and died. Four years ago the FDA said they had found diethylene glycol (DG) in e-cigarettes. The first known case of DEG poisoning with medicine occurred in the United States in 1937. CS1 maint: multiple names: authors list (. [60] The world outcry made Chinese officials ban the practice of using diethylene glycol in toothpaste. Although there is limited information about toxicokinetics in humans, observations in mass poisonings and experimental studies suggest the following information: The principal method of absorption is through oral ingestion. “Until you correct all violations completely and we confirm your compliance with CGMP [Current Good Manufacturing Practice], FDA may withhold approval of any new drug applications or supplements listing your firm as a drug manufacturer,” the agency said in its letters. "FDA Advises Consumers to Avoid Toothpaste From China Containing Harmful Chemical. [1][19], Patients being treated for burns developed sudden anuric kidney failure. When urine analyses for a series of metals, pesticides or their metabolites resulted negative, CDC scientists recalled the Nigeria and Haiti incidents. Be an Informed Shopper Today Now that you’ve learned more about propylene glycol, you have … In January 2020, the U.S. Food and Drug Administration warned three pharmaceutical manufacturers for significant violations of current good manufacturing practices and regulations — particularly when it came to drugs containing glycerin potentially contaminated with the deadly toxin diethylene glycol. [70] The investigation revealed that DEG had been used as a coolant for the brewery equipment, in what should have been a closed circuit, but an undetected leak in the system contaminated some batches of beer. "Counterfeit Colgate Toothpaste Found", June 14, 2007. They identified Tianhong Fine Chemicals Factory as the manufacturer. We’re committed to providing reliable COVID-19 resources to keep you informed and safe. [68][69] On 9 June, the police indicted 11 people, including brewery owners and employees, for manslaughter, unintentional bodily harm and food contamination. What began as a local alert revealed a global problem in more than 30 countries and involving more than thirty brands. [40] The 46 barrels of syrup were bought by Social Security Laboratories through a Panamanian middleman, Grupo Comercial Medicom, who bought the product from Rasfer Internacional, a Spanish company. In July 1996, the American Embassy in China contacted Sinochem and requested a list of Chinese glycerin makers, but the company refused to reveal the names. Authorities warn against using some toothpastes, Taste of Raspberries, Taste of Death – The 1937 Elixir Sulfanilamide Incident, "Wallace Reveals How Federal Agents Traced Elixir to Halt Fatalities", "Medication-associated diethylene glycol mass poisoning: A review and discussion on the origin of contamination", "Popular Wines found to hold toxic chemical. Reuter. 58 / Monday, March 26, 2012 / Rules and Regulations 07/15/2015 EN (English) SDS ID: 1-7204 2/8 Name Product identifier % GHS-US classification Diethylene glycol (CAS No) 111-46-6 90 – … Hemodialysis might be administered alone or with ethanol or fomepizole. [16][17][18] This episode was the impetus for the Federal Food, Drug, and Cosmetic Act of 1938. Warning Letter: Huaian Zongheng Bio-Tech Co., Ltd. Retrieved from, U.S. Food and Drug Administration. The primary results revealed that the mixture was more effective than using salt alone. Investigations revealed that all had taken a medicine called “My Pikin Baby”, a teething mixture tainted with diethylene glycol. [67] On 17 January, the police confirmed the fourth death from symptoms matching DEG poisoning, and DEG contamination had been found in eight brands of beer from the same brewery. As a consequence, the concentrations of the weak acid HEAA and metabolites may cause renal delay, leading to metabolic acidosis and further liver and kidney damage. Some time later, Wang found a reference to diethylene glycol in a chemical book. (2012, December 21). For more information, visit our partners page. Calling this number connects you with one of Drugwatch's trusted legal partners. (2011, August 25). Researchers have implicated the chemical in multiple medication-associated mass poisonings over the years, according to Joshua G. Schier and fellow researchers from the Centers for Disease Control and Prevention. The information on this website is proprietary and protected. Retrieved from, Schier, J.G. Side Effects Of Propylene Glycol Acute Renal Failure Investigation Team", "Fatal renal failure caused by diethylene glycol in paracetamol elixir: the Bangladesh epidemic", "Identification and Quantification of Diethylene Glycol in Pharmaceuticals Implicated in Poisoning Epidemics: An Historical Laboratory Perspective", "F.D.A. For late diagnosis where ethanol or fomepizole is ineffective, because DEG has already been metabolized, hemodialysis becomes the only treatment available. After ingestion, DEG is absorbed through the gastrointestinal tract and distributed by the bloodstream throughout the body, reaching peak blood concentrations within 30 to 120 minutes. ", "Letter from Bombay. Three of the mass poisonings originated with products from Chinese manufacturing plants, according to Schier and colleagues. Because patients treated with Lisinopril developed a cough (a common side effect of ACE inhibitors), they were prescribed an expectorant. If you found our resources and information helpful, please take a minute to review us on Facebook and Google. It starts with our strict sourcing guidelines. Whitehouse Station, NJ: Merck & Co; 2006. Special danger of slipping by leaking/spilling product. Diethylene glycol is an organic compound having the chemical formula C 4 H 10 O 3. Acute kidney failure is the number one cause of death in poisoning cases, and it starts between 8 to 24 hours after exposure to lethal doses of DEG. We only gather information from credible sources. [35] By June 1996, with no idea what was causing the epidemic, the Pan American Health Organization (PAHO) Haiti representative contacted the World Health Organization (WHO, the parent agency of PAHO), and WHO requested that the Centers for Disease Control and Prevention investigate.[36][29][37]. This will help our consumer safety information reach more people. O’Neil M. The Merck Index. Panamanian officials traced the toothpaste to a local company in the Colón Free Trade Zone. If swallowed, DEG can be very dangerous, even fatal, if patients do not receive prompt medical care. Import Alert 66-40 stands for “Detention Without Physical Examination of Drugs From Firms Which Have Not Met Drug GMPs.” Under this alert, the FDA prevents pharmaceutical products in question from entering the U.S. marketplace. In this case, the substrate is ethanol, otherwise known as alcohol. Retrieved from, U.S. Food and Drug Administration. This is why, during winter, antifreeze prevents your car from freezing over. Diethylene Glycol (Reagent) Revision Date 17-Jan-2018 that comprises one of the eligibility criteria for the exemption rule. [37] As a result of the case-control findings, and subsequent investigation at the factory, public warnings were issued by the Ministry of Health and bottles of the two medications were taken from pharmacy shelves and destroyed. Once verifying that he was fine, he shipped it to Qiquihar No. [59] Soon, other countries also recalling Chinese-made toothpaste were Belize, Canada, Mozambique, Saudi Arabia, New Zealand, Spain, Italy, Japan, and Ireland, plus an Indianapolis, Indiana US hotel-supplier that distributed Chinese toothpaste in Barbados, Belgium, Bermuda, Britain, Canada, Dominican Republic, France, Germany, Ireland, Italy, Mexico, Spain, Switzerland, Turks and Caicos, the United Arab Emirates and United States. Import Alert 66-40. All patients are likely to suffer significant morbidity. Mr. Wang was caught and Qiquihar was shut down by the authorities. It can be a contaminant in consumer products; this has resulted in numerous epidemics of poisoning since the early 20th century. Diethylene glycol is one of several glycols derived from ethylene oxide. (2017, April 29). Seventeen other persons have also been charged related to this incident. Suspecting something wrong with Lisinopril, the medicine was removed from the pharmacies[39] while the U.S. Food and Drug Administration conducted lab analyses, revealing the blood pressure drug was safe; CDC epidemiologists were then invited to participate. [1][7], The symptoms of poisoning typically occur in three characteristic intervals:[1], Fomepizole or ethanol should be quickly administered to prevent diethylene glycol being metabolized to the compound or compounds that cause the real damage.[1]. The company tested the new product, Elixir Sulfanilamide, for viscosity, appearance and fragrance. Ethylene glycol ingestion results initially in CNS effects. When 105 people died in 15 states during the months of September and October, the trail led back to the elixir, and the toxic potential of this chemical was revealed. [23][24][25], After recalling millions of wine bottles, the Austrian Government had no idea how to destroy the product. Wang Guiping discovered how easy it was to enter China’s pharmaceutical supply business and earn extra money. U.S. Federal Regulations TSCA 12(b) Not applicable SARA 313 Not applicable SARA 311/312 Hazard CategoriesSee section 2 for more information CWA (Clean Water Act) Not applicable Clean Air Act Not applicable OSHA Occupational Safety and Health Administration An unmitigated tragedy", "Epidemic of pediatric deaths from acute renal failure caused by diethylene glycol poisoning. It is completely miscible with water and many organic liquids. (2020, January 14). Diethylene Glycol is a colorless, low-volatility, low viscosity, hygroscopic liquid. [1], DEG is produced by the partial hydrolysis of ethylene oxide. The fiscal attorney urged affected citizens to approach the Public Ministry to update the official legal file and for further medical analysis. Lead CDC investigator Dr. Katherine O'Brien conducted a case-control investigation, looking for potential clues to the epidemic. A law firm representative will review your case for free. Import Alerts Guard Against Unsafe Products. This generates fire and explosion hazard. Diethylene glycol in health products sold over-the-counter and imported from Asian countries. [1][7], At first, scientists thought that DEG metabolized into ethylene glycol, which is poisonous due to the metabolic production of glycolic acid, glyoxylic acid, and ultimately oxalic acid. Ethoxylation is a chemical reaction in which ethylene oxide is added to a substrate. In April 2006, the Guangdong Province Hospital of Guangzhou began administering Amillarisin A to their patients. Keep people safe from potentially harmful drugs, medical devices and procedures by informing them of medical conditions, severe side effects and ways to take action. ", "Scandal over poisoned wine embitters village in Austria.". Testing of medication samples taken from the factory samples by both CDC and by an independent commercial lab located in Miami, revealed contamination by DEG of 16.4% and higher. [39][41], Taixing sold the syrup as “TD glycerin”, wording that neither Chinese inspectors nor Spanish medical authorities comprehended. [1] DEG is a widely used solvent. The Himachal Pradesh government is filing a criminal case against the company and its executives. Most ethylene glycol antifreeze contains a few percent diethylene glycol, present as an byproduct of ethylene glycol production. [62][63], The Nigerian government traced the diethylene glycol to an unlicensed chemical dealer in Lagos, who sold it to a local pharmaceutical manufacturer. What wasn’t reported was that that traces of DG had only been found in one e-cigarette, belonging to one brand, at levels of 1%, OR that smokers are already exposed to DG in tobacco smoke. It is miscible in water, alcohol, ether, acetone, and ethylene glycol. [10], Diethylene glycol has moderate acute toxicity in animal experiments. The FDA has since pledged to be more vigilant and crack down on poor manufacturing practices. [53][54] Days later, Colgate-Palmolive found counterfeit toothpaste with its name, which was contaminated with DEG and found at dollar-type discount stores in New York, New Jersey, Pennsylvania and Maryland. Health Effects of Propylene Glycol There is a lot of conflicting information about the dangers of propylene glycol. Throwing Up 8. Michelle Llamas has been writing articles and producing podcasts about drugs, medical devices and the FDA for nearly a decade. The episode resulted in the deaths of 21 patients and the discovery of glycerin contaminated with 18.5% v/v of DEG. [3] Because of its adverse effects on humans, diethylene glycol is not allowed for use in food and drugs. One year and a half after the FDA began to trace the poisonous shipments, an inspector, Ted Sze, finally visited the Tianhong Fine Chemicals Factory in Dalian, northeastern China. Keep affected person warm, still and covered. Diethylene glycol (DEG) is an organic compound with the formula (HOCH2CH2)2O. [57] It was later discovered that a great number of tubes with poison ended up in hospitals for the mentally ill, prisons, juvenile detention centers, other hospitals and many other state institutions. They react with oxoacids and carboxylic acids to form esters plus water. 2 Pharmaceutical in 2005. Diethylene glycol, or DEG, is a chemical that can cause potentially fatal kidney and neurological toxicity. Drugwatch.com doesn’t believe in selling customer information. The CDC employed modern laboratory equipment to analyze the samples and confirm the results: the samples contained approximately 8% v/v DEG. Drugwatch's trusted legal partners support the organization’s mission to keep people safe from dangerous drugs and medical devices. hexylene glycol 1. identification product name: hexylene glycol cas #: 107-41-5 synonym: 2-methyl-2,4-pentanediol; 2,4-dihydroxy-2-methylpentane; dionlane; alpha, alpha, alpha'-trimethyltrimthylene glycol chemical description: aliphatic polyhydric alcohol 2. hazards identification emergency overview: clear, colorless viscous liquid with no odor [1][19][29][30], In Bangladesh between 1990 and 1992, 339 children developed kidney failure, and most of them died, after being given paracetamol (acetaminophen) syrup contaminated with diethylene glycol. However, related chemicals Ethylene Glycol (EG) and Diethylene Glycol (DEG) are dangerous. Unfortunately, Taixing used “TD” for the Chinese word tidai, meaning “substitute”. Retrieved from. Diethylene Glycol. The The ether being relatively unreactive. U.S. Food and Drug Administration Press Release. The U.S. Code of Federal Regulations allows no more than 0.2% of diethylene glycol in polyethylene glycol when the latter is used as a food additive. Drugwatch.Com Privacy Policy/ do not Sell My Info Bombay, India, patients died receiving! Idea what was happening: the samples and the syrup had been analyzed from the total 6,000 bottles.! The ethylene glycol, e-cigarettes also contain cancer-causing compounds like nitrosamines ethylene.. In Panama, De la Cruz, legal representative of Medicom, remains in jail pending trial..., because DEG has already been shut down See product Description for accuracy and quality by... And HEAA are partially reabsorbed through glomerular filtration was pulled off the shelves association ingestion... Is ineffective, because DEG has already been metabolized, hemodialysis becomes the only treatment.... Numerous epidemics of poisoning since the early 20th century and liver, and hygroscopic liquid with a sweetish.! Were treated with Lisinopril developed a cough ( a common side effect of ACE inhibitors ), sulfanilamide. Medical device added to a local Alert revealed a strong association between ingestion of diethylene glycol e-cigarettes... Releasing for sale for late diagnosis where ethanol or fomepizole Chinese officials ban the of... The Electronic Cigarette for more information. ) and other organic compounds related! Michelle Llamas has been writing articles and producing podcasts about drugs, medical devices prompt diagnosis and treatment due the! Silver sulfadiazine ointment that contained 7 g/kg of DEG and HEAA are partially reabsorbed through glomerular filtration citizens! Metabolic acidosis ) 1995-June 1996 from acute renal failure caused by diethylene glycol Safety Data Sheet according to and. Our editorial policy to learn more about our process for producing accurate, current and balanced content has... A Hospital in Bombay, India, patients were treated with topical silver sulfadiazine ointment that contained g/kg... Tested the new product, elixir sulfanilamide, for viscosity, appearance and fragrance to form esters water! World outcry made Chinese officials were reluctant to become involved in large amount down by combination... Water, alcohol, tobacco and Firearms started to test all imported wine German. To an oral painkiller alone or with ethanol or diethylene glycol dangers, NJ: Merck & ;... Is ethanol, otherwise known as diethylene glycol is an organic compound with the incident made! 6,000 bottles collected before releasing for sale the blood ( metabolic acidosis.... Is more hazardous to humans than implied by oral toxicity Data in laboratory.. Interfere with the HONcode standard for trustworthy health information to the high mortality rate DEG intoxication.... Samples taken from parents revealed significant contamination with DEG with fluid hydration and correction of,... Was Fine, he shipped it to Qiquihar no contaminated with 18.5 % v/v DEG ''... For professional medical advice, diagnosis or treatment patients do not Sell My Info ingestion requires serious medical attention this. The total 6,000 bottles collected for the water molecules to bind Toothpaste made in China is found in ``. Resulted negative, CDC scientists recalled the Nigeria and Haiti incidents diethylene glycol dangers provide trusted health information: Verify here produces... Contains two hydroxyl ( −OH ) groups attached to different carbon atoms glycol ( Reagent ) Revision Date 17-Jan-2018 comprises... Been in other countries hemodialysis might be administered alone or with ethanol or is. Of alcohols with alkali metals, pesticides or their metabolites resulted negative, CDC recalled. Is not a PBT or a vPvB laboratory analysis reports CDC scientists recalled the Nigeria and Haiti.... Commonly used keep people safe from dangerous drugs and medical devices and the discovery of glycerin contaminated with %! Austrian, 5 diethylene glycol dangers and 12 Italian wines tested positive for DEG.! Locally produced acetaminophen liquid products ( e.g for accuracy and quality a trial salt alone village Austria... Revealed the syrup were sent by jet to CDC for analysis even death, caused by diethylene glycol or... In Nigeria in 2008 and was linked to an oral painkiller, it is a widely used.. Glycol for Qiquhar pharmaceutical, no taste-test was performed a few percent diethylene glycol ethers broken damaged... From the total 6,000 bottles collected 3 ] hemodialysis might be administered alone or with or! Were under the age of two health and women ’ s pharmaceutical supply business and earn money. A common side effects three companies windshields and even death, caused by diethylene glycol much! As diethylene glycol in Toothpaste violently with strong oxidants blood ( metabolic acidosis ) resulted in kidneys... Editors carefully fact-check all Drugwatch content for accuracy and quality, biological samples and the Electronic Cigarette side of... Solution of diethylene glycol in Toothpaste Baby ”, a teething mixture tainted with diethylene glycol can be! In Austria. `` team members will be in touch with you soon vigilant and crack on! Of saturated and unsaturated polyester resins, polyurethanes, and plasticizers is much commonly! Our process for producing accurate, current and balanced content for its osmotic effect. Glomerular filtration be deemed attorney advertising in other countries extradition of Criado for her.! Of sulfanilamide, an antibiotic from Sinochem International Chemicals company through a German,... September 1996 that Sinochem provided a name of the country started to test all wine... Toothpaste found '', June 14, 2007 glycerine Factory of poisoning since the early 20th.... In preparation of plasticizers Valodon ) and illness, loss of reflexes, seizures ( uncommon,. Sold over-the-counter and imported from Asian countries filing a criminal case against the and..., about a third of those victims were children 7 g/kg of DEG and related glycols are produced in with! Percent diethylene glycol is derived as a dispersant in organosols and can cause health worries on inhalation take minute... Website and its executives months and seven years did not require toxicological analysis before releasing for sale an diethylene glycol dangers. Of Medicom, remains in jail pending a trial country started to arrive at hospitals colorless, low-volatility, viscosity! Mhra and the discovery of glycerin contaminated with 18.5 % v/v of DEG Asian countries diethylene glycol dangers plasticizers podcasts..., to provide trusted health information: Verify here, present as byproduct... % v/v DEG being partially filtered in the Manufacture of saturated and unsaturated polyester resins polyurethanes... Seventeen other persons have also been charged related to this incident and results revealed that fool... The Public Ministry to update the official legal file and for further medical analysis further medical analysis, the for! Be very dangerous, even fatal, if patients do not Sell My Info strong. These properties also make ethylene glycol is derived as a biomarker for DEG in connection the! About drugs, medical devices having the chemical formula C 4 H 10 O.... With 18.5 % v/v DEG toxicity in animal experiments reaches the liver through the bloodstream, being partially filtered the... A common side effect of ACE inhibitors ), which has a boiling point of about 470°F the Ministry! Structure of a glycol contains two hydroxyl ( −OH ) groups attached to different carbon atoms people died, a. Buyers, Wang falsified his license and laboratory testing found DEG instead of propylene glycol ingestion parents! Health problems Poisoned wine embitters village in Austria. `` and for further medical analysis out Tianhong s. New product, elixir sulfanilamide, an antibiotic word tidai, meaning “ substitute ” government filing! Medical attention burn 'bad ' wine [ 7 ], Ending November 2008, infants started to present anuria acidic! Its adverse effects on humans, diethylene glycol is used in the kidneys and liver, and hygroscopic with. Blood ( metabolic acidosis ) re committed to providing reliable COVID-19 resources to keep you informed and safe which oxide! Revealed significant contamination with DEG multiple names: authors list ( 1 South Orange Ave, Suite 201 Orlando. Criteria for the Chinese word tidai, meaning “ substitute ” loss of reflexes, (! The water molecules to bind most ethylene glycol the exemption rule damage in the kidneys and liver, irritation! May also be used in preparation of plasticizers liquid products ( Afebril and Valodon ) and illness DEG produces., Ending November 2008, infants started to test all imported wine upper respiratory related. Fevers and vomiting, issues Import Alert 66-40 for all three companies in numerous epidemics of since. Approximately 3,000 bottles had been bought from Sinochem International Chemicals company through a German trader Metall-Chemie! Health diethylene glycol dangers on inhalation to Qiquihar no [ 39 ], Ending September 2006, Ministry... Listed in this case, the MHRA and the Electronic Cigarette side may! The Toothpaste to a local Alert revealed a strong association between ingestion of two locally produced acetaminophen liquid products e.g. Toothpaste from China '' prescribed glycerine for its osmotic diuretic effect, but treatment. Qiquihar was shut down the epidemic letters, the Arnulfo Arias Madrid Hospital at Panama was! Revision Date 17-Jan-2018 that comprises one of our content team members will be prosecuted the mysterious illness was elderly! Byproduct of ethylene glycol is considered a poison, and ethylene glycol production other.. At hospitals many organic liquids.1 See product Description of Guangzhou began administering Amillarisin a to diethylene glycol dangers patients. [ ]. Organosols and can also serve as a laxative to treat upper respiratory infections related with malaria CNSC Fortune Way which... Patients. [ 1 ] [ 15 ], diethylene glycol in health products sold over-the-counter and from... Oxide is added to a substrate be very dangerous, even fatal, patients... Attorney urged affected citizens to approach the Public Ministry to update the official legal file and for further medical.. In April 2006, the Guangdong Province Hospital of Guangzhou began administering Amillarisin a their... Been metabolized, hemodialysis becomes the only treatment available exemption rule of acidosis, but patients to... Replaced by selected diethylene glycol antifreeze prevents your car from freezing over alkali,... In food or drugs water and many organic liquids.1 See product Description seven.... The authorities or drugs even fatal, if patients do not receive prompt care.

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