Saturday, June 5, 2010

Saturday June 5, 2010

Q: Role of Ethanol, Fomepizole and Hemodialysis are well known in Methanol toxicity. Describe the role of bicarbonate in Methanol toxicity meanwhile above 3 treatments/antidote get arranged?


Answer: It is true that Ethanol, Fomepizole and Hemodialysis are mainstay of treatment in Methanol toxicity but often ignored is the role of bicarbonate in Methanol toxicity.

Actually Methanol itself has a relatively low toxicity. The adverse effects are from the accumulation of formic acid, a metabolite of methanol metabolism. Upon ingestion, methanol is quickly absorbed in the gastrointestinal tract and metabolized in the liver. In the first step of degradation, methanol is transformed to formaldehyde via the enzyme alcohol dehydrogenase (ADH). The next step is the transformation of formaldehyde to formic acid via the enzyme aldehyde dehydrogenase. Bicarbonate may help to decrease the amount of active formic acid. In addition, Bicarbonate potentially may reverse visual deficits
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