All patient should be questioned about ethanol abuse. Ethanol withdrawal should be monitored for or prevented with prophylactic use of benzodiazepines. Brent, J. Great overview of the pathophysiology, stabilization and treatment of EG poisoning. Emergency Medicine Clinics of North America.
Overview of ethanol abuse epidemiology, pathophysiology and treatment. Ethanol withdrawal is also discussed. Kraut, JA, Kurtz, I. Clinical Journal of the American Society of Nephrology. Concise overview of diagnosis, clinical findings and management of toxic alcohol poisonings.
Journal of Forensic Sciences. Concludes that clinical evidence of ethanol inebriation does not correlate well with blood alcohol concentrations. Cochrane Database of Systematic Reviews. CD A good overall review of the treatment of ethanol withdrawal. Journal of Toxicology Clinical Toxicology. Journal of Toxicol Clinical Toxicology.
Clinical Toxicology. Nice overview of therapeutic options. Annals of Emergency Medicine. Comparison of fomepizole and ethanol for the treatment of toxic alcohol poisonings.
New England Journal of Medicine. The sentinel paper describing the use of fomepizole for ethylene glycol toxicity. Journal of Clinical Psychopharmacology. British Journal of Addiction. Overview of the CIWA scale. Jones, AW.
Forensic Science International. General review of the rate of ethanol metabolism. Jones, AW, Andersson, L. Journal of Forensic Science. Concise prospective study evaluating the rate of ethanol metabolism in drinking drivers. Pharmacological Reviews. Discusses the effects of ethanol on various receptor subtypes. Journal of Medical Toxicology. In-depth review of ethanol kinetics. Overview of the development of tolerance for ethanol.
Australian and New Zealand Journal of Ophthalmology. Clinical review of methanol's ocular pathophysiology in two cases of human poisoning. McMartin, K. Review of the pathophysiology of ethylene glycol-induced acute kidney injury. Veterinary and Human Toxicology. Retrospective review of cases of methanol toxicity; clinical signs and outcomes are reported.
All rights reserved. No sponsor or advertiser has participated in, approved or paid for the content provided by Decision Support in Medicine LLC. Show More. Login Register. We want you to take advantage of everything Cancer Therapy Advisor has to offer.
To view unlimited content, log in or register for free. Register now at no charge to access unlimited clinical news, full-length features, case studies, conference coverage, and more. Table I. Alcohol Molecular weight Conversion Factor Methanol 32 3. How do I know this is what the patient has An atraumatic patient who presents with altered sensorium or clinical inebriation is suggestive of ethanol intoxication, though other conditions may be involved. Differential diagnosis A patient suspected of an ethanol or toxic alcohol ingestion should be evaluated for all of the following: hypoglycemia, alcoholic ketoacidosis, trauma, and other ingestions.
Confirmatory tests Confirmatory testing involves documenting a blood serum concentration. The chemical depresses the central nervous system in the same way as ethanol, so in large quantities, it can kill someone in the same way as ordinary alcohol poisoning , but according to the National Institutes of Health, even 2 to 8 ounces of methanol can be fatal to an adult.
This is because alcohol dehydrogenase, the same enzyme that breaks down ethanol, converts methanol into formaldehyde. This process is somewhat slow, which explains why the symptoms of methanol poisoning can sometimes take hours or days to manifest, but formaldehyde, once present, is processed very swiftly into formic acid, a chemical found in ant stings. An unchecked buildup of formic acid, which is slow to metabolize, damages the ocular nerve possibly resulting in the permanent blindness often associated with the consumption of bad bootleg liquor and can eventually lead to death.
Because of its toxicity, methanol is sometimes added to ethanol products with industrial uses, such as solvents, to rule out their potential as beverages. By adding methanol, manufacturers can avoid the taxes associated with alcoholic beverages and sell their products at lower costs. These deliberately poisoned products are sometimes used by bootleggers to cheaply pad out liquor.
However drinking methanol the same way leads to poisoning of a different, irreversible kind. We look at the chemistry and biochemistry involved in two very similar molecules, and how they affect the body in different ways.
There have been many cases around the world of people experiencing methanol poisoning after consuming illegally sold alcoholic beverages. Especially in developing countries where small bars cannot afford the price of taxed liquor, they turn to create their own.
Low concentrations of methanol occur naturally in most alcoholic beverages without causing any harm. However higher levels have been found when processes — especially microbiological — fail to meet aseptic conditions, therefore introducing wild yeasts into the fermentation process. These microbes have an enzyme called pectin methyl esterase, which is able to convert pectin — a naturally occurring chemical found in fruits — to methanol.
Once consumed, the side effects that come with methanol ingestion can be mild to severe. Symptoms of methanol toxicity include a slight inebriation for 10 to 20 hours, followed by weakness, vomiting, pain, confusion, severe lowering of blood pH, ocular toxicity, and eventually coma and death 1.
The differences in the way methanol and ethanol affect the body are actually… not very different at all. Methanol on its own is not very toxic, comparable in fact, to your everyday alcohol in that they can inhibit brain functions through central nervous system depressant properties.
Your body, however, is wired to break chemicals down so that they can be excreted through processes collectively known as metabolism. One of the first steps in metabolism tends to be oxidation.
0コメント