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Methanol poisoning

Methanol poisoning. Czech Republic Ibrahim Ali. 27 people in Czech Republic and 4 people in Poland dead Similar case in Estonia, 2001, 68 people dead, 43 disabled Prohibition era in the USA (1920) - death toll in the thousands. Methanol.

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Methanol poisoning

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  1. Methanol poisoning Czech Republic Ibrahim Ali

  2. 27 people in Czech Republic and 4 people in Poland dead • Similar case in Estonia, 2001, 68 people dead, 43 disabled • Prohibition era in the USA (1920) - death toll in the thousands

  3. Methanol • CH3OH -Colourless, flammable liquid with a slightly alcoholic smell • Used as a feedstock, fuel, solvent, antifreeze • Used to fortify illicit spirits (moonshine)

  4. Toxicity • Highly toxic to humans via two mechanisms • Median lethal dose is 1–2 mL/kg of pure methanol (estimated 4 shots at 40%)

  5. Mechanism • CNS depression • Similar to ethanol: decreased rate of breathing (bradypnoea), decreased heart rate (bradycardia), and loss of consciousness leading to coma and eventually death. • Due to similarity to ethanol’s effect on the body, methanol poisoning is not suspected until the patient sees a “snow storm”, where the visual apparatus has already been damaged

  6. Metabolism to formic acid • Inhibition of cytochrome c oxidase

  7. First set of symptoms • Initial inebriation – especially if ethanol is also ingested. • 12-24h delay, then acidosis sets in and the second set of symptoms arise

  8. Second set of symptoms • CNS - inebriation progressing to coma, convulsions • Retinal - blurred vision, photophobia, visual acuity loss, dilated non-reactive pupils, optic nerve hyperaemic - becoming oedematous • GIT - nausea, vomiting • Cardiac - tachycardia, hypertension progressing to hypotension and cardiogenic shock • Respiratory - tachypnoea

  9. Treatment • Stabilising airway, breathing and circulation, limiting acidosis and reducing uptake of and removing methanol • Traditionally the use of ethanol has been the basis of treatment however, where available, 4-Methyl pyrazole (fomepizole) should be used first • Haemodialysis

  10. Prognosis • Depending on severity of exposure • Permanent optic nerve damage occurs in 25% of survivors with permanent blindness/visual disturbance • Hypotension • Acidosis • Coma • Death • However, with early detection and intervention, the survival rate is generally quite good.

  11. References • http://www.thenews.pl/1/10/Artykul/112167,Poland-on-alert-after-19-die-from-methanol-poisoning-in-Czech-Republic • http://www.bbc.co.uk/news/world-europe-19608461 • http://en.wikipedia.org/wiki/2012_Czech_Republic_methanol_poisonings • http://curriculum.toxicology.wikispaces.net/2.2.5.2.5+Methanol • http://en.wikipedia.org/wiki/Methanol_poisoning#Toxicity • http://science.howstuffworks.com/innovation/edible-innovations/moonshine3.htm • http://en.wikipedia.org/wiki/P%C3%A4rnu_methanol_tragedy • http://en.wikipedia.org/wiki/Ethanol_poisoning#Acute_alcohol_poisoning • http://uk.reuters.com/article/2012/09/14/czech-alcohol-idUKL5E8KEKLR20120914 • http://en.wikipedia.org/wiki/Fomepizole • http://www.radio.cz/en/section/curraffrs/despite-repeated-warnings-bootleg-alcohol-claims-more-victims-daily

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