Treatment of toxic alcohol poisoning

M3 India Newsdesk Jan 17, 2019

With a high index of suspicion of toxic alcohol ingestion, early visual symptoms, and unexplained anion gap metabolic acidosis, toxic alcohol poisoning can be clinically diagnosed for prompt and effective management.

In India, adulteration of alcoholic drinks is most commonly done by adding methanol to alcoholic drinks since it is believed that methanol provides a quick kick to the person drinking it, and since methanol is cheaper than ethanol it becomes the perfect choice for adulteration.

Toxic alcohol poisoning- When to suspect?

Methanol poisoning is suspected when a person is seen with some vague generalised symptoms but may also have:

Alcohol ingestion history within the past two days
Shortness of breath
Severe eye pain, blurred vision, or double vision
Severe acidic pH on urine examination
Fundoscopy shows inflammation and detection of a portion of optic nerve (papillitis)
Severe metabolic acidosis with a pH <7.3 on ABG ( Arterial Blood Gas) without any obvious cause on history or clinical examination

Complications of toxic alcohol poisoning

Within 0.5 to 4 hours of taking only methanol, clinical manifestation of poisoning starts with nausea, vomiting, abdominal pain, confusion, drowsiness, and central nervous system suppression. In this stage, patients usually do not seek any help.
If methanol is taken with ethanol, then these manifestations of methanol poisoning will be delayed and will be seen only after 12 to 24 hours.
Acidaemia is a significant laboratory finding. Tachypnea and hyperventilation (Kussmaul’s breathing) are the response of the body to acidaemia which is diagnosed in the presence of acute dyspnoea with normal cardiovascular and respiratory finding.
In the central nervous system, signs of hypoglycemia and convulsions are signs of severe toxic alcohol intoxication.

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