Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.
In Reply: As Dr Sotos points out, intravenous
(IV) ethanol may be an appropriate antidote for methanol and ethylene glycol
poisoning. Although methanol and ethylene glycol themselves are not highly
toxic, they are converted to metabolites that are (ie, formaldehyde and formic
acid, or glycoaldehyde and glycolic acid, respectively). In addition to gastric
decontamination, supportive care, and hemodialysis in selected patients, the
treatment strategy for these poisonings is to block the initial step in their
metabolism by inhibiting alcohol dehydrogenase, which converts the alcohol
to an aldehyde.
Blondell RD, Dodds HN, Sexton LK. Ethanol in Hospital Formularies—ReplyEthanol in Hospital Formularies—Reply. JAMA. 2003;289(18):2361. doi:10.1001/jama.289.18.2361-a