Methanol poisoning

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1. Serum level:

    1. ≥20 mg/dl in blood ⇒ symptomatic pt.

    2. ≥50 mg/dl in blood ⇒ ophthalmic symptoms

    3. ≥150 mg/dl ⇒ death

2. Orders:

    1. folic acid 1mg/kg q4h IV

    2. Keep pH >7.2

    3. Ethanol

        1. 1.8 cc/kg stat then 0.2 cc/kg, 43% PO

        2. 8 cc/kg stat then 1.2 cc/kg/hr 10% IV

        3. if use 20% PO ⇒ use double dose

        4. if on H.D ⇒ use double dose

    4. Fomepizole 15mg/kg stat then 10 mg/kg q12h *4

        1. if not resolved after 2 days ⇒ increase dose up to 15 mg/kg q12h

    5.  Hemodialysis if:

        1. refractory acidosis

        2. ophthalmopathies

        3. cns problems

        4. >50 mg/dl serum level

        5. >30 cc/kg intake

    6. Continue dialysis till serum level <20 mg/dl or for at least 8 hours