Document Detail


Fomepizole for the treatment of methanol poisoning.
MedLine Citation:
PMID:  11172179     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Methanol poisoning may result in metabolic acidosis, blindness, and death. The inhibition of alcohol dehydrogenase is fundamental to the treatment of methanol poisoning. We performed a multicenter study to evaluate fomepizole, an inhibitor of alcohol dehydrogenase, in the treatment of patients with methanol poisoning. METHODS: We administered intravenous fomepizole to 11 consecutive patients who presented with methanol poisoning at a participating center. Serial clinical and laboratory studies, including measurements of plasma formic acid and fomepizole, were performed. The outcomes measured were the preservation of visual acuity, the resolution of metabolic acidosis, the inhibition of formic acid production, the achievment of therapeutic plasma concentrations of fomepizole with the dosing regimen, residual illness or disability, and death. RESULTS: Plasma formic acid concentrations were detectable in eight patients, and these concentrations were closely correlated with the initial arterial pH values (r=0.92, P<0.001). In response to fomepizole, plasma formic acid concentrations fell and metabolic abnormalities resolved in all patients. Nine patients survived. Seven patients initially had visual abnormalities, but at the end of the trial no surviving patient had any detectable visual deficits related to methanol poisoning. Fomepizole had few adverse effects. The two patients who died had anoxic brain injury that was present at the time of enrollment. During treatment, methanol had an elimination half-life of 54 hours. CONCLUSIONS: Fomepizole appears to be safe and effective in the treatment of methanol poisoning.
Authors:
J Brent; K McMartin; S Phillips; C Aaron; K Kulig;
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Publication Detail:
Type:  Clinical Trial; Journal Article; Multicenter Study; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  The New England journal of medicine     Volume:  344     ISSN:  0028-4793     ISO Abbreviation:  N. Engl. J. Med.     Publication Date:  2001 Feb 
Date Detail:
Created Date:  2001-01-25     Completed Date:  2001-02-08     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0255562     Medline TA:  N Engl J Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  424-9     Citation Subset:  AIM; IM    
Affiliation:
Toxicology Associates, and Division of Emergency Medicine, University of Colorado Health Sciences Center, Denver 80210, USA. jeffrey.brent@uchsc.edu
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MeSH Terms
Descriptor/Qualifier:
Acidosis / drug therapy,  etiology
Adolescent
Adult
Alcohol Dehydrogenase / antagonists & inhibitors*
Antidotes / adverse effects,  therapeutic use*
Enzyme Inhibitors / therapeutic use
Female
Formic Acids / blood
Humans
Injections, Intravenous
Male
Methanol / blood,  poisoning*
Middle Aged
Poisoning / drug therapy
Prospective Studies
Pyrazoles / adverse effects,  blood,  therapeutic use*
Grant Support
ID/Acronym/Agency:
FDR-001256-01/FD/FDA HHS
Chemical
Reg. No./Substance:
0/Antidotes; 0/Enzyme Inhibitors; 0/Formic Acids; 0/Pyrazoles; 64-18-6/formic acid; 67-56-1/Methanol; 7554-65-6/fomepizole; EC 1.1.1.1/Alcohol Dehydrogenase

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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