Methyl Alcohol

Methyl alcohol (methanol, wood alcohol) is used as a solvent, a component of antifreeze, and an adulterant of alcoholic beverages. While this chemical is only mildly toxic, it is oxidized to formaldehyde and formic acid, which produce severe acidosis and are responsible for the symptoms of methanol abuse. Neuropathological changes in the

form of shrinkages and degeneration of neurons, primarily in the parietal cortex, have been reported. y The oxidation and excretion of methyl alcohol is so slow that toxic symptoms do not develop for 12 to 48 hours, although they may last for several days. Once apparent, toxic symptoms involve the visual apparatus, CNS, and the gastrointestinal and respiratory tracts. Early symptoms include nausea, vomiting, weakness, abdominal pain, vertigo, and headache. Additional symptoms may include restlessness, incoordination, and, in severe cases, delirium and hallucinations. Confusion and memory deficits are also reported. In severe cases, stupor, coma, tonic muscle contractions, hyperactive reflexes, visual loss, parkinson-like extrapyramidal syndrome, and convulsions may also be seen. In the most severe cases, death occurs from respiratory failure.

Treatment involves frequent measurements of blood methanol, carbon dioxide, bicarbonate, and pH. Ethyl alcohol may be administered to retard the conversion of methanol into toxic formaldehyde and formic acid. Bicarbonate can be given to correct severe acidosis. Serum potassium levels should be monitored because bicarbonate tends to decrease potassium. Administration of folic acid may accelerate the metabolism of formic acid to carbon dioxide. Either peritoneal dialysis or hemodialysis can be used in patients with methanol blood concentrations of over 50 mg.

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