Treatment of acute methanol poisoning with fomepizole

Methanol poisoning may cause metabolic acidosis, visual abnormalities and neurological dysfunction and may also result in severe sequelae or death. The treatment indicated is the administration of antidotes which inhibit the metabolization of the methanol by the alcohol dehydrogenase enzyme (ADH). T...

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Autores:
Tipo de recurso:
Fecha de publicación:
2004
Institución:
Universidad del Rosario
Repositorio:
Repositorio EdocUR - U. Rosario
Idioma:
eng
OAI Identifier:
oai:repository.urosario.edu.co:10336/23168
Acceso en línea:
https://repository.urosario.edu.co/handle/10336/23168
Palabra clave:
4 methylpyrazole
Alcohol dehydrogenase
Bicarbonate
Methanol
Adult
Alcohol blood level
Alcohol consumption
Alcoholism
Article
Case report
Clinical feature
Consciousness disorder
Disease course
Drug tolerability
Fatality
Human
Intraocular hemorrhage
Male
Metabolic acidosis
Metabolic inhibition
Methanol poisoning
Neurologic disease
Neuropathy
Treatment outcome
Visual acuity
Visual disorder
4-methilpyrazole
Fomepizole
Methanol
Rights
License
Abierto (Texto Completo)
Description
Summary:Methanol poisoning may cause metabolic acidosis, visual abnormalities and neurological dysfunction and may also result in severe sequelae or death. The treatment indicated is the administration of antidotes which inhibit the metabolization of the methanol by the alcohol dehydrogenase enzyme (ADH). Traditionally, ethyl alcohol has been used for this purpose, but recently, fomezipole, an inhibitor of alcohol dehydrogenase, has been introduced. We report on the first patient treated with this antidote in Spain. A 59-year-old man with a history of chronic alcoholism was admitted to the Emergency Department due to altered consciousness. Severe metabolic acidosis was detected and the patient admitted having consumed some 50 mL of rubbing alcohol. The serum methanol concentration was 0,24 g/l. Treatment was begun with sodium bicarbonate and fomepizole at a dose of 15 mg/kg, which was well-tolerated with no reappearance of acidosis. Reduced visual acuity and a small haemorrhage in the right optic papilla were observed, both of which were compatible with a toxic neuropathy.