Methanol Intoxication

From Anvita Health Wiki

Contents 1 Pathology 2 Clinical-manifestations 3 Laboratory 4 Complications 5 Management 6 More General Terms 7 Additional Terms 8 References

Pathology

• when ingested, methanol is rapidly metabolized to formaldehyde & to formic acid
• formic acid is slowly metabolized & causes the pathology
• major damage occurs at the retrolaminar optic nerve with intra- axonal swelling & organelle destruction
• little to no change is seen in the retina
• affects the basal ganglia; ith severe intoxication, hemorrhagic & nonhemorrhagic damage of the putamen

Clinical-manifestations

• metabolic acidosis
• central nervous system dysfunction
• optic disc congestion
• pupillary response to light is compromised &, subsequently, is lost
• complete blindness is common

Laboratory

• anion gap metabolic acidosis

• arterial blood gas
• Chem7 (calculate anion gap)

• serum Na+
• serum bicarbonate
• serum chloride

• serum ketones are negative
• direct measurement of methanol in serum

Complications

• 
  
• disease interaction(s) of alcohol intoxication with overflow incontinence

Management

• fomepizole (Antizol) agent of choice [1]
• ethanol 10% solution

• loading dose: 10 mL/kg
• maintenance dose: 1.5 mL/kg
• titrate to blood alcohol level of 22 mmol/L (100 mg/dL)

• hemodialysis
• blindness sometimes responds to therapy [2]

More General Terms

• toxicity; poisoning; overdose

Additional Terms

• alcohol intoxication
• methanol; methyl alcohol

References

1. Medical Knowledge Self Assessment Program (MKSAP) 11, 14, 15, American College of Physicians, Philadelphia 1998, 2006, 2009
2. eMedicine: Medicine [1]

methanol intoxication