Which therapy is central to the management of methanol or ethylene glycol poisoning?

Which therapy is central to the management of methanol or ethylene glycol poisoning?

• A. Oxygen therapy
• B. Activated charcoal
• C. Dialysis
• D. Immediate surgery

Answer: (C)

Dialysis is central to management because it rapidly removes methanol or ethylene glycol from the blood and corrects the severe metabolic disturbances these poisons cause. After ingestion, these alcohols are converted into toxic metabolites that drive acidosis and organ injury (for example, visual damage with methanol and kidney injury with ethylene glycol). While antidotes like fomepizole (or ethanol) block further formation of metabolites, they don’t quickly clear the toxins already present. Dialysis directly eliminates both the parent compounds and their toxic metabolites and helps restore normal acid-base and electrolyte balance, which is why it’s the mainstay in significant or life-threatening cases. Indications include marked acidosis, high toxin concentrations, end-organ effects, or failure to respond to antidotes. Oxygen therapy and activated charcoal are not the primary treatments for toxin removal in this scenario, and immediate surgery is not indicated.

Dialysis is central to management because it rapidly removes methanol or ethylene glycol from the blood and corrects the severe metabolic disturbances these poisons cause. After ingestion, these alcohols are converted into toxic metabolites that drive acidosis and organ injury (for example, visual damage with methanol and kidney injury with ethylene glycol). While antidotes like fomepizole (or ethanol) block further formation of metabolites, they don’t quickly clear the toxins already present. Dialysis directly eliminates both the parent compounds and their toxic metabolites and helps restore normal acid-base and electrolyte balance, which is why it’s the mainstay in significant or life-threatening cases. Indications include marked acidosis, high toxin concentrations, end-organ effects, or failure to respond to antidotes. Oxygen therapy and activated charcoal are not the primary treatments for toxin removal in this scenario, and immediate surgery is not indicated.