Evidence supporting the use of: Aliphatic alcohol
For the health condition: Poisoning (general)
Synopsis
Source of validity: Scientific
Rating (out of 5): 4
Aliphatic alcohols, particularly ethanol (a primary aliphatic alcohol), have a well-established scientific basis for use in the treatment of certain types of poisoning, specifically methanol and ethylene glycol poisoning. The therapeutic mechanism relies on ethanol’s ability to act as a competitive substrate for the enzyme alcohol dehydrogenase, which is responsible for metabolizing both methanol and ethylene glycol into their toxic metabolites (formaldehyde, formic acid, glycolic acid, and oxalic acid). By saturating the enzyme, ethanol reduces the conversion of these toxic alcohols into their harmful metabolites, allowing more time for safe excretion from the body.
This intervention is supported by numerous clinical guidelines and case reports, particularly in settings where the preferred antidote, fomepizole, is unavailable. The effectiveness of ethanol in this context is well-documented, and it has long been included in standard toxicology references and emergency medicine protocols. However, it should be noted that "aliphatic alcohol (unspecified)" is a broad term; only certain aliphatic alcohols like ethanol are effective and safe for this use—others (such as methanol or isopropanol) are themselves toxic and not used therapeutically for poisoning.
In summary, there is strong scientific evidence supporting the use of ethanol (an aliphatic alcohol) as an antidote for methanol and ethylene glycol poisoning. This practice is based on well-understood biochemical principles and extensive clinical experience. The evidence rating is not the maximum because ethanol has side effects and fomepizole is now preferred when available.
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