What is the Treatment for Methanol Poisoning?

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  • Written By: Rebecca Harkin
  • Edited By: Allegra J. Lingo
  • Last Modified Date: 18 July 2019
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Treatment for methanol poisoning typically involves removing and neutralizing the methanol still in the stomach, neutralizing metabolic acidosis and preventing the remaining methanol from being broken down, and removing the un-metabolized methanol and any remaining methanol metabolites. When methanol is ingested, the body breaks down the compound into toxic parts or metabolites which causes metabolic acidosis, and blood and other body fluids become highly acidic. Metabolic acidosis can be fatal if not treated quickly.

If a patient is discovered soon after ingesting methanol, quick action can be performed by the emergency response team to remove any methanol still in the stomach by inducing vomiting or pumping out the poison. Activated charcoal, a fairly universal poison neutralizer, can also be administered to conscious and willing patients through a drink or to unconscious patients after intubation to protect the lungs. The activated charcoal absorbs the methanol, is not digested by the stomach, passes through the intestinal tract, and is eliminated. Any methanol which was digested by the stomach or reached the digestive tract before the stomach pumping and activated charcoal treatment will be broken down and begin to poison the body.


The second stage of treatment for methanol poisoning is to neutralize the metabolic acidosis caused by the metabolism of methanol to formic acid. Diagnosis of metabolic acidosis is difficult unless methanol poisoning is suspected because symptoms are fairly general and include vomiting, chest pain, heart palpitations, and an anxious mental state. Treatment begins by performing an arterial blood gas to test the body's pH level, or how acidic the blood is, and the bicarbonate level, or the ability of the blood to buffer against elevated acid levels. To neutralize the elevated acid level, sodium bicarbonate will be administered intravenously to regulate the pH balance, and folinic or folic acid will be given to help metabolize the formic acid. The patient will often be given intravenous fluids and electrolytes, airway management, and be evaluated and treated for any existing neurological or cardiovascular problems resulting from the methanol poisoning.

In the third stage of treatment, the goal is to prevent further metabolism of the methanol and to remove unmetabolized methanol and any remaining toxic metabolites. Alcohol dehydrogenases are enzymes which catalyze the breakdown of alcohols and, in the case of methanol poisoning, allow for the breakdown of methanol to formic acid. Ethanol or fomepizole are typically administered to prevent the metabolism of methanol because they act as competitive inhibitors to alcohol dehydrogenases, meaning they bind to alcohol dehydrogenases and leave them inactive and useless. As a result, ethanol or fomepizole prevents or slows the metabolism of methanol into its toxic byproducts, allowing methanol to be eliminated through the kidneys. Hemodialysis will also be performed to clear the blood of any methanol and formic acid still remaining.


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Post 3

Dialysis must be the scariest part about methanol poisoning treatment. I think it involves cleaning the blood through the use of a machine that pumps blood out and then pumps it back in. But if it's necessary, it has to be done because it will save a life. It's basically the last option that doctors will use if nothing else is working.

Post 2

I had no idea that sodium bicarbonate can be administered intravenously. I knew that bicarbonate can help neutralize acidity. That's why it's often an ingredient in antacids for people with acidic stomachs. But I'm hearing about its use in methanol poisoning for the first time. It's great if something so simple can help treat methanol poisoning and reduce its effects.

Post 1

My cousin was in the hospital recently for methanol poisoning. He went in as soon as he realized what had happened. In the hospital, they told him that either he has to drink activated charcoal, or his stomach will be pumped. I guess the idea of having his stomach pumped was very scary to him because he chugged down a huge glass of activated charcoal. He said he had to really force the last gulp down because it tasted so awful.

Thankfully though, since he was treated quickly and most of the methanol did not get digested by the body, he did not suffer serious consequences. If he had gone into the hospital later though, I'm sure he would have had many issues.

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