S61(3) - Toxic Alcohol

Question 1

Methanol
Oral ingestion, inhalation, or dermal absorption
15 mL may be fatal ~ 0.25ml/kg

Answer 1

true

Question 2

Metabolized to formic acid
Inhibits cellular respiration leads to cell death
Acidosis increases leading to increases in formate leads to increases of uptake into tissues
Blindness due to direct retinal toxicity

Answer 2

true

Question 3

Methanol –alcohol dehydrogenase–> Formaldehyde –aldehyde dehydrogynase –FORMIC ACID

Answer 3

true

FORMIOC ACID IS TOXIC

Question 4

methanol toxicity Visual complaints, occasionally producing blindness “snow storm,” “seeing the wind

Answer 4

true

Acidosis may be delayed

Question 5

Methanol Management

Indications for antidotal therapy

Answer 5

History or suspicion of methanol ingestion AND
anion gap acidosis OR osmol gap
Methanol > 25 mg/dL

Question 6

Methanol Management
Goals
Methanol level < 25 mg/dL
Asymptomatic

Answer 6

true

Question 7

Methanol Management
Antidote: Alcohol dehydrogenase
Ethanol
Fomepizole

Answer 7

true

Question 8

Methanol Management
Shunting therapy
Folic acid – to accelerate transformation from formic acid

Answer 8

true

Question 9

Methanol Management
Adjunctive
Bicarbonate therapy – increase pH and formic acid dissociation

Answer 9

true

Question 10

Methanol Management
Emergent toxicity
Hemodialysis
Especially useful if level > 45 mg/dL
Or severe visual symptoms, CNS symptoms, acidosis

Answer 10

true

Question 11

Where is methanol found

Answer 11

windshiekd washer fluid