Therefore, after initially stabilizing the patient, the treatment goal focuses on inhibiting the first step in metabolism which is conversion by the enzyme alcohol dehydrogenase. Alcohol dehydrogenase has a much higher affinity for ethanol than for methanol or ethylene glycol. Hence, one approach is to competitively inhibit enzymatic conversion of methanol and ethylene glycol with doses of ethanol. This compound appears more promising than competitive inhibition with ethanol because of its rapid onset and duration of action. Hemodialysis also is recommended to enhance the removal of toxic compounds.
Folic acid is a cofactor for the metabolism of formic acid, a toxic methanol metabolite.
Thiamine is a cofactor for the conversion of lactate, which is commonly present in both methanol and ethylene glycol poisoning. Recently, the FDA approved Antizol , an alcohol dehydrogenase inhibitor, as an antidote to ethylene glycol poisoning. This drug alone, or in combination with dialysis appears to be effective in relieving the effects of ethylene glycol intoxication. There are several sites relating to alcoholism, a major predisposing factor to methanol and ethylene glycol abuse. For other sites relating to alcoholism , please visit our page on that addiction.