T51.1
DESCRIPTION
No longer found in methylated spirits as methanol replaced with less toxic agents 10-20 years ago. Methanol may be found in stove or model fuels, or in antifreeze and windscreen washes. Methanol may result in an ethanol-like inebriation in the early phase.
Presentation:
- Ingestion of methanol results in initial mild inebriation (headache, confusion, nausea and vomiting) followed by an asymptomatic period.
- Later, toxic metabolite (formic acid) formation results in severe high anion gap metabolic acidosis, and retinal toxicity (with visual impairment to total blindness).
Anion gap calculation = Na – (CI + HCO3) (Normal = 8-16)
MEDICINE TREATMENT
If acidotic or visual disturbances;
Start with immediate ethanol antidote therapy (See Ethylene glycol poisoning), and evaluate for urgent dialysis, if available.