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Medicine Toxicology bd710135

Methyl alcohol poisoning is treated with

A
Disulfiram
B
Ethyl alcohol
C
Flumazenil
D
Clonidine
High-Yield Explanation
Ans. b (Ethyl alcohol). (Ref. Harrison, Medicine, 18th/Ch. 47)TREATMENT OF METHYL ALCOHOL POISONING# Patient in quiet, dark room# Gastric lavage with sodabicarb and Combat acidosis by IV sodabicarb infusion (the most vital measure, prevents retinal damage).# Ethanol 100mg/dl (retards methanol metabolism), Fomepizole (specific alcohol dehydrogenase inhibitor) and Haemodialysis are useful.PoisioningFeaturesRxEthylene Glycol (anti-freeze)High anion gap Metabolic acidosis and severe damage to the CNS, heart, lungs, and kidneys.Prompt institution of a saline or osmotic diuresis, thiamine and pyridoxine supplements, fomepizole or ethanol, and hemodialysis.Methanol (wood alcohol)Causes high anion gap metabolic acidosis, and its metabolites formaldehyde and formic acid cause severe optic nerve and CNS damage.Similar to that for ethylene glycol intoxication, including general supportive measures, fomepizole, and hemodialysis .Isopropyl Alcohol (as little as 150 ml of rubbing alcohol, solvent, or de-icer can be fatal)A plasma level >400 mg/dL is life-threatening. Isopropyl alcohol differs from ethylene glycol and methanol in that the parent compound, not the metabolites, causes toxicity, and an AG acidosis is not present because acetone is rapidly excreted. Ethylene glycol, Methanol and Isoporpyl alcohol, all 3 cause an elevated osmolal gap, but only the first two cause a high-AG acidosis.Treated by watchful waiting and supportive therapy; IV fluids, pressors, ventilatory support if needed, and occasionally hemodialysis for prolonged coma or levels >400 mg/dL.Treat Benzodiazepines overdose with flumazenil (competitive antagonist at GABA receptor).

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