Methanol Poisoning and Its Treatment
International Journal of Medical Toxicology and Forensic Medicine,
Vol. 10 No. 1 (2020),
19 February 2020
,
Page 26639
https://doi.org/10.32598/ijmtfm.v10i1.26639
Abstract
Background: Methanol is a toxic alcohol found in illegal liquor, and its poisoning may cause death if not treated timely and properly. In 2018, methanol toxicity in Iran increased dramatically. Regarding the high prevalence of methanol toxicity, its high mortality rate, and the cost of treatment as well as the importance of timely diagnosis in the treatment of this condition, we decided to review methanol toxicity, its signs, symptoms, diagnosis, and treatment.
Evidence Acquisition: We searched for articles on reliable databases such as Embase and Medline from January 2018 to May 2018 using the following keywords: “methanol,” “toxic alcohol,” and “ethanol toxicity treatment.”
Results: This review discusses how to diagnose methanol toxicity by using clinical signs and symptoms and laboratory examinations; it also suggests new treatments. Meanwhile, we provide alternatives for diagnosis in case of shortages of tests in the emergency department.
Conclusion: Diagnosis of ethanol toxicity due to non-specific signs and symptoms, late patient’s referral, and lack of proper history-taking can be very difficult and delay the onset of treatment. There is also no clear scientific evidence as to whether ethanol or fomepizole should be used as the first choice of therapy for methanol toxicity because there is no direct comparison between these two antidotes regarding their effectiveness and safety. The appropriate antidote is chosen depending on the availability, cost, accessibility of hemodialysis, and the physician’s experience. If the therapist does not have enough experience, it is easier to use fomepizole.
- Methanol
- Alcohol
- Poisoning
- Toxicity
How to Cite
References
Haghdoost AA, Emami M, Esmaili M, Soberinia A, Nezhad Ghaderi M, Mehrolhassani MH. Survey the status and causes of alcohol consumption: A case study of the epidemic alcohol poisoning in Rafsanjan in 2013. Journal of Rafsanjan University of Medical Sciences. 2015; 13(10):991-1006.
Moral AR, Çankayalı İ, Sergin D, Boyacılar Ö. Neuromuscular functions on experimental acute methanol intoxication. Turkish Journal of Anaesthesiology and Reanimation. 2015 ;43(5):337-43. [DOI:10.5152/TJAR.2015.13471] [PMID] [PMCID]
Ashurst JV, Nappe TM. Methanol Toxicity. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020-2019.
Rietjens SJ, De Lange DW, Meulenbelt J. Ethylene glycol or methanol intoxication: which antidote should be used, fomepizole or ethanol. The Netherlands Journal of Medicine. 2014; 72(2):73-9.
Iranian Legal Medicine Organization. 2020[Cited 2010Mar15]. Available from: www.LMO.ir.
Aghababaeian H, Araghi Ahvazi L, Ostadtaghizadeh A. The methanol poisoning outbreaks in Iran 2018. Alcohol and Alcoholism. 2019; 54(2):128-30. [DOI:10.1093/alcalc/agz005] [PMID]
Mégarbane B. Treatment of patients with ethylene glycol or methanol poisoning: focus on fomepizole. Open Access Emergency Medicine (OAEM). 2010; 2:67-75. [DOI:10.2147/OAEM.S5346] [PMID] [PMCID]
Liesivuori J, Savolainen H. Methanol and formic acid toxicity: Biochemical mechanisms. Pharmacol Toxicol. 1991 ;69:157-63. [DOI:10.1111/j.1600-0773.1991.tb01290.x] [PMID]
Ng PC, Long BJ, Davis WT, Sessions DJ, Koyfman A. Toxic alcohol diagnosis and management: An emergency medicine review. Internal and Emergency Medicine. 2018; 1;13(3):375-83. [DOI:10.1007/s11739-018-1799-9] [PMID]
Hassanian-Moghaddam H, Bahrami-Motlagh H, Zamani N, Fazeli SA, Behnam B. Intracranial hemorrhage in methanol toxicity: Challenging the probable heparin effect during hemodialysis. Journal of Research in Pharmacy Practice. 2017 ;6(3):186-9. [DOI:10.4103/jrpp.JRPP_17_39] [PMID] [PMCID]
Beauchamp GA, Valento M, Kim J. Toxic alcohol ingestion: Prompt recognition and management in the emergency department [digest]. Emergency Medicine Practice. 2016; 18(9 Suppl Points & Pearls):S1-S2.
Barceloux DG, Bond GR, Krenzelok EP, Cooper H, Vale JA. American academy of clinical toxicology practice guidelines on the treatment of methanol poisoning. Journal of Toxicology: Clinical Toxicology. 2002 ;40(4):415-46. [DOI:10.1081/CLT-120006745] [PMID]
McMartin K, Jacobsen D, Hovda KE. Antidotes for poisoning by alcohols that form toxic metabolites. British Journal of Clinical Pharmacology. 2016; 1;81(3):505-15. [DOI:10.1111/bcp.12824] [PMID] [PMCID]
Gallagher N, Edwards FJ. The diagnosis and management of toxic alcohol poisoning in the emergency department: A review article. Advanced Journal of Emergency Medicine. 2019 ;3(3):e28. [DOI:10.22114/ajem.v0i0.153]. [PMID] [PMCID]
Rietjens SJ, De Lange DW, Meulenbelt J. Ethylene glycol or methanol intoxication: Which antidote should be used, fomepizole or ethanol. The Netherlands Journal of Medicine. 2014; 72(2):73-9.
Faessel H, Scherrmann JM, Houze P, Baud FJ. 4-methylpyrazole monitoring during haemodialysis of ethylene glycol intoxicated patients. European Journal of Clinical Pharmacology. 1995; 49(3):211-3. [DOI:10.1007/BF00192381] [PMID]
Jobard E, Harry P, Turcant A, Marie Roy P, Allain P. 4-methylpyrazole and hemodialysis in ethylene glycol poisoning. Journal of Toxicology: Clinical Toxicology. 1996; 34(4):373-7. [DOI:10.3109/15563659609013806] [PMID]
Brent J. Fomepizole for ethylene glycol and methanol poisoning. The New England Journal of Medicined. 2009; 360(21):2216-23. [DOI:10.1056/NEJMct0806112] [PMID]
Jacobsen D, McMartin KE. Antidotes for methanol and ethylene glycol poisoning. Clinical Toxicology. 1997; 35(2):127-43. [DOI:10.3109/15563659709001182] [PMID]
Faessel H, Scherrmann JM, Houze P, Baud FJ. 4-methylpyrazole monitoring during haemodialysis of ethylene glycol intoxicated patients. European Journal of Clinical Pharmacology. 1995; 49(3):211-3. [DOI:10.1007/BF00192381] [PMID]
- Abstract Viewed: 948 times
- PDF Downloaded: 912 times