№ 9Toxicology14 min read
Ethanol, methanol and ethylene glycol poisoning
1. Big picture
Ethanol, methanol, and ethylene glycol are alcohols, but their danger is different:
- Ethanol mainly causes central nervous system depression, hypoglycemia, aspiration, trauma, hypothermia, and sometimes alcoholic ketoacidosis.
- Methanol is dangerous because it is metabolized to formic acid, causing high anion gap metabolic acidosis + visual toxicity.
- Ethylene glycol is dangerous because it is metabolized to glycolic and oxalic acids, causing high anion gap metabolic acidosis + acute kidney injury + calcium oxalate crystals.
The exam pattern is simple:
**Drunk-looking patient + high osmol gap early + high anion gap metabolic acidosis
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