Methyl Alcohol Poisoning

Methyl Alcohol Poisoning


METHANOL  (METHYL ALCOHOL)  POISONING:

  • Highly  toxic  alcohol.
  • Metabolized  to  formaldehyde  (by alcohol dehydrogenase)  and  formic  acid  (by acetaldehyde  dehydrogenase).
  • Can  be  present  in  contaminated country  liquor used  to  denature  ethanol.

Accumulation  of  formic  acid 

  1. causes  toxic  effects in  methanol poisoning.
  2. Results  in lactic  acidosis/high  anion  gap  metabolic  acidosis with  low  plasma
  3. Bicarbonates,  blindness  due to retinal  damage, papilledema  and optic  atrophy

Symptoms  of poisoning

  • Nausea, vomiting,
  • Dizziness,  confusion,
  • Headache,  abdominal  pain,  respiratory
  • Depression,  cyanosis,  acute  tubular  necrosis,
  • Hypothermia,  fixed  dilated  pupils,  visual  disturbance  (blurring  of  vision photophobia)
  • Odor  of spirit  in  breath.

 Fatal dose : in  adults  is  60-240  ml in  adults, but as little  as l5  ml can cause  blindness

Treatment:

  • gastric lavage and sodium bicarbonate  (to treat  acidosis)
  • ethanol is  useful  because  it  competitively  inhibits  the  conversion  of methanol  to formic acid.
  • Fomepizole  can also  be  used as it  is  a specific inhibitor  of alcohol  dehydrogenase.
  • Folic  acid or folinic  acid  enhance the  metabolism  of formic  acid  to  CO2 .
  • Hemodialysis may  also  be   used in  severe poisoning.
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