Is Ethylene glycol (EG) Diethylene glycol (DEG) Polyethylene glycol (PEG) Toxic?

Yes, Ethylene glycol (EG), Diethylene glycol (DEG), and Polyethylene glycol (PEG) are all compounds that have varying degrees of toxicity depending on exposure and the specific context. 

Here's a breakdown of their toxicity profiles:

1. Ethylene glycol (EG):

   • Toxicity: EG is moderately toxic and ingestion can be harmful or fatal. Ingesting even small amounts can result in ethylene glycol poisoning. Symptoms of poisoning include intoxication, headache, dizziness, nausea, and in severe cases, kidney failure, and death.
   • Ethylene glycol and its toxic byproducts first affect the central nervous system (CNS), then the heart, and finally the kidneys.
   • Ethylene glycol is only mildly irritating to skin and mucous membranes and is not absorbed well through the skin.
   • Characteristic histopathological changes include renal tubular focal degeneration, atrophy, and interstitial inflammation. 
   • While metabolic acidosis and neurological symptoms such as dizziness, seizures, and stupor can develop due to EG ingestion, these are primarily due to the metabolic disturbances and toxic metabolites rather than direct inflammation of the brain. 
     
   • Usage: It's commonly used in antifreeze and coolant for vehicles.

2. Diethylene glycol (DEG):

   • Toxicity: DEG is also toxic to humans. Ingestion can lead to symptoms like nausea, vomiting, abdominal pain, and kidney damage. There have been numerous cases in the past where DEG-contaminated products have led to mass poisonings.
   • When consumed, DEG causes severe systemic and neurologic complications, including coma, seizures, peripheral neuropathy, and hepatorenal failure.
   • DEG poisoning is associated with a range of symptoms, including metabolic acidosis, acute kidney injury, and neurological symptoms like drowsiness, coma, and convulsions. Some case reports and studies have suggested that DEG can cause encephalopathy (brain dysfunction), which might be mistaken for or associated with brain inflammation.  
   • Usage: DEG is used in a variety of applications including as a solvent and in some brake fluids.
   • Safety Measures: Just like with EG, if someone is suspected of consuming DEG, immediate medical attention is needed.

3. Polyethylene glycol (PEG):

   • Toxicity: PEG is a family of compounds of varying molecular weights. The toxicity of PEG depends on its molecular weight. Lower molecular weight PEGs can cause diarrhea and other gastrointestinal symptoms, Urticaria has been observed after using PEG electrolyte lavage solution following topical administration. Generally, PEGs are considered to be low in toxicity if ingested in large amounts and are used in a variety of pharmaceutical and cosmetic products.
   • Usage: It's widely used in laxatives, personal care products, and as an excipient in many pharmaceuticals. PEG is also used in food as a moisture-preserving agent.
   • Safety Measures: Though PEG is generally considered safe for its intended uses, it's still essential to follow guidelines and avoid consuming products not meant for ingestion.
     

   Always remember, the dose makes the poison. Small amounts of many substances might not cause harm, but larger quantities can be dangerous.

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Subject related articles will updated as they become available. 

List of contexts in which these compounds are found:

Many medications utilize Ethylene glycol (EG), Diethylene glycol (DEG), and Polyethylene glycol (PEG) as excipients or solvents. However, it's crucial to note that DEG is not typically used in legitimate pharmaceutical manufacturing due to its toxicity. Instead, instances of DEG in medications usually arise from contamination or illicit manufacturing.

1. Ethylene glycol (EG):

   • EG is not commonly found in medications. It's more typically found in industrial applications like antifreeze.

2. Diethylene glycol (DEG):

   • DEG has historically been associated with medicinal contamination events, where it was erroneously used as a cheaper alternative to other solvents. For instance, in the 1930s, the Elixir Sulfanilamide disaster in the US was due to DEG contamination, leading to numerous deaths.
   • Given its toxic nature, DEG is not a legitimate or approved excipient for medications.

3. Polyethylene glycol (PEG):

   • PEG is a common excipient in various pharmaceutical preparations due to its diverse properties and general safety profile.
   • Examples:
     • Laxatives: Products like MiraLAX contain PEG 3350 as the active ingredient.
     • Bowel prep solutions: Solutions such as GoLYTELY, used for colonoscopy preparation, contain PEG.
     • Injectable medications: PEG is used to modify certain drugs, such as PEGylated interferons (e.g., Pegasys) or PEGylated liposomal doxorubicin (e.g., Doxil), to prolong their action or improve their delivery.
     • Skin creams and ointments: PEG is used as an ointment base in various skin medications.
     • Tablet and capsule fillers: PEG is sometimes used as a filler or binder in oral medications.
     • COVID-19 vaccines: Some of the mRNA vaccines, like the Pfizer-BioNTech vaccine, utilize PEG in their lipid nanoparticles, which has been a point of investigation for rare allergic reactions.

If you have concerns about specific medications, it's essential to read the ingredient list or consult with a pharmacist or physician.