4.5 Review

Antidotes Against Methanol Poisoning: A Review

Journal

MINI-REVIEWS IN MEDICINAL CHEMISTRY
Volume 19, Issue 14, Pages 1126-1133

Publisher

BENTHAM SCIENCE PUBL LTD
DOI: 10.2174/1389557519666190312150407

Keywords

Alcohol dehydrogenase; aldehyde dehydrogenase; catalase; ethanol; folic acid; fomepizole; formic acid; formaldehyde; methanol; tetrahydrofolate; therapy

Funding

  1. long-term organization development plan Medical Aspects of Weapons of Mass Destruction
  2. Specific research funds (Faculty of Military Health Sciences, University of Defense, Czech Republic)
  3. Technological Agency of the Czech Republic [TACR TH03030336]

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Methanol is the simplest alcohol. Compared to ethanol that is fully detoxified by metabolism. Methanol gets activated in toxic products by the enzymes, alcohol dehydrogenase and aldehyde dehydrogenase. Paradoxically, the same enzymes convert ethanol to harmless acetic acid. This review is focused on a discussion and overview of the literature devoted to methanol toxicology and antidotal therapy. Regarding the antidotal therapy, three main approaches are presented in the text: 1) ethanol as a competitive inhibitor in alcohol dehydrogenase; 2) use of drugs like fomepizole inhibiting alcohol dehydrogenase; 3) tetrahydrofolic acid and its analogues reacting with the formate as a final product of methanol metabolism. All the types of antidotal therapies are described and bow they protect from toxic sequelae of methanol is explained.

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