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A patient comes into the emergency room having accidentally ingested methanol (a component in anti-freeze). Methanol toxicity can lead to blindness, neurological issues, or death and must be treated quickly. Methanol is oxidized by the enzyme alcohol dehydrogenase (ADH) to produce formaldehyde which is then converted to formic acid. ADH has a higher affinity to ethanol, where it functions to oxidize ethanol into acetaldehyde with the end product of the pathway being acetic acid (vinegar).
-Knowing what you know about enzyme function, what would be your suggested course of treatment?
A)Give plenty of fluids and monitor the patient.
B)Give the patient acetic acid.
C)Give the patient high levels of ethanol and carefully monitor.
D)Keep the patient warm and rested and let it take its course.
E)Give the patient an enzyme inhibitor so no formaldehyde is produced.

Question

Quizplus · Accepted Answer

Ethanol is a competitive inhibitor of ADH, meaning it can block the oxidation of other substrates (like methanol) by occupying the active site of the enzyme. Therefore, administering high levels of ethanol can prevent the conversion of methanol to formaldehyde and ultimately to formic acid, allowing the body to excrete the methanol safely. Careful monitoring is still necessary to avoid potential side effects of ethanol toxicity.

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