Poisoning - Methanol

Notes
  • Methanol is metabolized by the alcohol dehydrogenase (ADH) to produce toxic metabolite (formic acid).
  • The commonest cause of methanol poisoning in East Africa is the homemade alcohol that is laced with methanol to make it stronger.
Symptoms
  • Drowsiness
  • Getting drunk
  • Muscle weakness
  • Eye damage that leads to blurred vision, papilloedema and then blindness
  • Cardio-pulmonary depression
  • Cerebral edema
  • Coma
  • Seizure
  • Death
  • Parkinsonian motor impairment for survivors
Management
  • Intensive supportive care
  • Gastric lavage within 4 hrs
  • IV bicarbonate 50%
  • Ethanol (10%)

*It competes with methanol for alcohol dehydrogenase to inhibit production of toxic metabolites.

*Dose

**10% ethanol is prepared in 5-10% dextrose (for oral or IV use).

**Loading dose: IV 600mg or 7.6mL/kg/hr of 10% ethanol. **Maintenance dose: IV 100-200 mg or 1.26-2.52ml/ kg/hr of 10% OR Orally 0.15mL/kg/hr (max. 100mg/dL)

**Chronic alcoholics and those on haemodialysis require double dose)

  • Haemodialysis
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