Methanol and Formic Acid Toxicity: Biochemical Mechanisms

Liesivuori, Jyrki; Savolainen, H.

doi:10.1111/j.1600-0773.1991.tb01290.x

Cited by 344 publications

(230 citation statements)

References 57 publications

Supporting

Mentioning

221

Contrasting

Unclassified

Order By: Relevance

“…The well known toxicity of methanol is due to its metabolites, formaldehyde and formic acid, which act as metabolic poisons to cause histotoxic hypoxia and subsequently vasodilatation (Liesi vuori and Savolainen, 1991). Raskin and Sokoloff (1970) reported a small alcohol dehydrogenase ac tivity in rat brain homogenate as compared with liver homogenate (1 :4,000), and nonspecific cata lase or peroxidase activities could also metabolize alkyl alcohols (Liesivuori and Savolainen, 1991). Based upon the relatively large mass of alcohol to be metabolized by the isolated arteriole in the organ bath and the rapidity of the vessel response, it seems unlikely that alcohol metabolites would ac cumulate in the organ bath.…”

Section: Discussionmentioning

confidence: 99%

Differential Effects of Alcohols on Intracerebral Arterioles. Ethanol Alone Causes Vasoconstriction

et al. 1995

J Cereb Blood Flow Metab

View full text Add to dashboard Cite

Summary:We compared the effect of the acute applica tion of ethanol, methanol, I-propanol, I-butanol, urea, and mannitol (1-100 mM) on the basal tone of isolated cannulated rat intracerebral arterioles to determine if the response of these arterioles to ethanol could be attributed to alteration of membrane fluidity or changes in osmolal ity. These arterioles spontaneously developed tone to 62.0 ± 8.4% of passive diameter (44.2 ± 11.9 vs. 70.9 ± 14.7 fJ-m). Ethanol caused a dose-dependent reduction in arteriolar diameter starting at 3 mM (p = 0.03), reaching a diameter of 81.4 ± 3.0% of basal tone at 100 mM. In comparison, all other agents tested caused the arterioles to dilate, with the exception of I-propanol, which pro duced inconsistent vessel responses. At 100 mM concen tration, methanol, I-butanol, urea, and mannitol dilated

show abstract

Section: Discussionmentioning

confidence: 99%

Differential Effects of Alcohols on Intracerebral Arterioles. Ethanol Alone Causes Vasoconstriction

et al. 1995

J Cereb Blood Flow Metab

View full text Add to dashboard Cite

show abstract

“…It is a medical emergency where rapid administration of antidotes, fomepizole or ethanol, preventing toxic metabolite formic acid formation by blocking alcohol dehydrogenase (ADH) is crucial for successful treatment 4,5 . Formate anions as the products of methanol metabolism have a strong cytotoxic effect by inhibition of mitochondrial respiration 6,7 . The accumulation of formic acid results in metabolic acidosis, lactacidemia, visual impairment and damage to the basal ganglia, especially when the concentration rises to 9-11 mmol/L (approximately 300-400 mg/L) (ref.…”

Section: Introductionmentioning

confidence: 99%

Fomepizole in the treatment of acute methanol poisonings: Experience from the Czech mass methanol outbreak 2012-2013

Zakharov¹,

Navrátil²,

Pelclová³

2014

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

View full text Add to dashboard Cite

Objective. During an outbreak of mass methanol poisonings in the Czech Republic in 2012-2013, fomepizole was applied as an alternative antidote to ethanol. We present the laboratory data, clinical features, adverse reactions, and treatment outcomes in all patients treated with fomepizole. Methods. Combined retrospective and prospective case series study in 25 patients, median age 50 (16-73) years, 18 males and 7 females. Results. There were 24% fatalities, 36% survivors without health impairment, and 40% survivors with sequelae. All the patients who died were comatose on admission; the mortality was 50% among patients in a coma. The median intensive care unit length of stay was six (2-22) days. The median total dose of fomepizole was 2 (1-9) g. Complications were observed in 7/25 cases: aspiration pneumonia (4), sepsis (2), bleeding (2), malignant arrhythmia (1), delirium tremens (1), and rebound of acidosis (1). The patients who survived without impairment were less acidotic than those who died or survived with sequelae (P<0.01). No difference in serum methanol and formate was found between the three groups. Conclusion. There is no evidence whether fomepizole is a more efficient antidote than ethanol with regards to the hospital mortality. The possibility of delirium tremens in the patients with a history of chronic alcohol abuse has to be taken in consideration. The benefits of fomepizole were indirect: no need to monitor serum ethanol's level during the hemodialysis in severely poisoned patients and less working overload on ICU doctors treating several poisoned patients simultaneously.

show abstract

“…Typical signs and symptoms of acute MeOH poisoning include metabolic acidosis, central nervous disorder, and vision abnormality caused by formic acid, a toxic metabolite of MeOH 1, 2. Rapidly absorbed from the gastrointestinal tract, MeOH is metabolized first to formaldehyde by alcohol dehydrogenase, and finally to formic acid by aldehyde dehydrogenase in the liver 3, 4, 5.…”

Section: Discussionmentioning

confidence: 99%

Mild manifestation of methanol poisoning half a day after massive ingestion of a fuel alcohol product containing 70% ethanol and 30% methanol: a case report

Yoshizawa

Kamijo

Fujita

et al. 2018

Acute Medicine & Surgery

View full text Add to dashboard Cite

CaseIs fomepizole necessary after massive ingestion of a mixture of methanol and ethanol? We report the case of a 37‐year‐old man who was transported to our Poison Center 12 h after ingesting 500 mL of fuel alcohol containing 70% methanol and 30% ethanol in a suicide attempt. On admission, he presented only with somnolence and mild metabolic acidosis. We hypothesized that most of the ethanol had been metabolized.OutcomeAs the estimated serum concentration of methanol was lethal (242.6 mg/dL), fomepizole was given i.v. and hemodialysis was carried out twice, resulting in complete recovery. Later, the serum concentrations of both methanol and ethanol on admission were found to be 224.1 and 0.51 mg/dL, respectively.ConclusionTherapeutic intervention was delayed by half a day after ingestion of a product containing methanol and ethanol in the present case. If the patient had arrived earlier, he may have only been treated with hemodialysis, but not fomepizole.

show abstract

Methanol and Formic Acid Toxicity: Biochemical Mechanisms

Cited by 344 publications

References 57 publications

Differential Effects of Alcohols on Intracerebral Arterioles. Ethanol Alone Causes Vasoconstriction

Differential Effects of Alcohols on Intracerebral Arterioles. Ethanol Alone Causes Vasoconstriction

Fomepizole in the treatment of acute methanol poisonings: Experience from the Czech mass methanol outbreak 2012-2013

Mild manifestation of methanol poisoning half a day after massive ingestion of a fuel alcohol product containing 70% ethanol and 30% methanol: a case report

Contact Info

Product

Resources

About