Methyl Alcohol Poisoning


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Methyl Alcohol Poisoning:

Methyl Alcohol Poisoning Presented by- Dr. Neeraj Kumar M.O. CHC Pooh, Kinnaur Medical Officer De-addiction Training at Parimahal , Shimla 23/06/2012 6/24/2012 1

Case Study:

Case Study Last Sunday, when I was on emergency duty at Regional Hospital Reckongpeo, Police brought 25 yr male with altered sensorium. There was alleged H/O alcohol intake with other two friends . 6/24/2012 2

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They started drinking some country made liquor at 8:00 am. At 10:00 am he managed to come out of his house and told people that his two friends are unconscious and he is also feeling drowsy & c/o palpitation, pain abdomen and vomiting. People went to his room and found that two other had already died. They informed police and brought the patient to ER. 6/24/2012 3

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After 6 hrs in hospital, when he gained some consciousness he c/o diminution of vision. Pupils B/L reacting to light. But was unable to count fingers even at 50 cm. 6/24/2012 4

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What is the case? 6/24/2012 5


Toxicity 10 mL of pure methanol can cause permanent blindness by destruction of the optic nerve 30 mL is potentially fatal, although the median lethal dose is typically 100 mL 6/24/2012 6

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SIGN & SYMPTOMS Headache, dizziness, & vertigo Nausea, vomiting & epigastric pain Cardiac functions are depressed Muscular weakness, dyspnoea & cyanosis Visual disturbances - blurred vision - photophobia - optic neuritis 6/24/2012 8

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Subnormal temperature Delirium& coma (2-3 days) Bradycardia & KUSSMAUL BREATHING Urine is strongly acidic and contains - albumin - acetone - formic acid Death occurs from respiratory failure 6/24/2012 9


Treatment Unabsorbed Methanol should be removed by gastric lavage . Supportive Measures: ■Correction of Acidosis ■Control of seizures ■Maintenance of nutrition ■Alkalization of urine enhances excretion of formic acid 6/24/2012 10

Specific Measures:

Specific Measures Administration of Ethanol to saturate alcohol dehydrogenase. 5 % solution of Ethanol is prepared loading dose 15 ml/kg maintenance dose 2-3 ml/kg/hour orally. Can also be given intravenously. Folic acid has been used to enhance conversion of formate to carbon dioxide and water. The dose is 50 mg IV 4 hourly for 24 hours. 6/24/2012 11

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Hemodialysis enhances elimination of Methanol and Formic acid and is indicated when Methanol levels exceed 50 mg/dl. 4-methylpyrazole , an inhibitor of alcohol dehydrogenase . 6/24/2012 12

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6/24/2012 13

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6/24/2012 14 Pooh, Kinnaur Thank you

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