METANOL ZEHİRLENMESİ: OLGU SUNUMU

Yıl 2011, Cilt: 2 Sayı: 1, 14 - 16, 01.01.2011

Cemal Kavalcı , Eylem Sezenler Gülsüm Kavalcı Yunsur Çevik Mustafa Turan

Öz

Metanol zehirlenmesi şiddetli hastalık ve ölüme sebep olabilen klinik
bir durumdur. 26 yaşında erkek hasta acil servisimize bulantı, karın
ağrısı ve görme bozukluğu şikayetleri ile başvurdu. Öyküsünden önceki
akşam, yaklaşık 12 saat önce, sarhoş olmak amacı ile 500 ml ispirto
ve 200-300 ml kadar kolonya içtiği öğrenildi. Hasta metil alkol zehirlenmesi
olarak kabul edildi. %10’luk etanol yükleme dozu 10 ml/
kg %5 dextroz içinde intravenöz yoldan ve idame dozu saatte 1,5ml/kg/
saat’den verildi. Şiddetli asidozu olan hastaya 1 mEq/kg’dan NaHCO3
verildi ve dializ yapıldı. Fomepizol 15 mg/kg yükleme, 12 saatte bir 10
mg/kg idame 3 kez verildi. Yoğun bakıma yatırılan hasta 6 gün sonra
şifa ile taburcu edildi.

Anahtar Kelimeler

Acil, Zehirlenme, Metanol

METHANOL POISONING CASE REPORT

Öz

Methanol intoxication may be cause of severe illness and death. A 26
years old male presented to the emergency department with the complaints
of abdominal pain, nausea and blurred vision. It was learned
from his history that he took 500 mL of spirit and 200-300 ml of cologne
to be well primed with liquor. The patient was accepted as methanol
poisoning and 10% ethanol solution was given as 10 ml/kg in %5 dextrose
loading dose, and 1.5 ml/kg every hour infusion. Because of the
severe acidosis, 1 m Eq/kg NaHCO3 was given patient and he was
taken to dialysis. Fomepizole was given as 15 mg/kg loading dose, and
then three times 10 mg/kg every 12 hours was given. The patient was
sent to intensive care unit and he was discharged after 6 days by cure

Anahtar Kelimeler

Emergency, Poisoning, Methanol

Kaynakça

• Berk WA, Henderson WV. Alcohols. In Tintinalli JE, Kelen GD, Stapczynski JS, editor. Emergency Medicine. A Comprehensive Study Guide. 5th ed. New York: McGraw Hill; 2000. p.1103-1109.
• Wiener SW. Toxic Alcohols. In Flomenbaum NE, Goldfrank LR, HoffmanRS, Howland MA, Lewin NA, Nelson LS editor. Gold- frank’s Toxicologic Emergencies. 8th ed. New York: McGraw Hill; 2006. p.1146-1460.
• Hsu HH, Chen CY, Chen FH, Lee CC, Chou TY, Zimmerman RA. Optic atrophy and cerebral infarct caused by methanol intoxica- tion: MRI. Neuroradiology 1997;39:192-194.
• Halavaara J, Valanne L, Setala K. Neuroimaging supports the clinical diagnosis of methanol poisoning. Neuroradiology 2002;44:924-928.
• Hantson P, Wallemacq P, Brau M, Vanbinst R, Haufroid V, Ma- hieu P. Two case of acute methanol poisoning partially treated by oral 4-methyl pryazole. Intensive Care Med 1999;25:528-531
• Megarbone B, Boron SW, Trout H, Hantson P, Jaeger A, Krencker E et al. Treatment of acute methanol poisoning with fomepizole. Intensive Care Med 2001;27:1370-1378
• DeBrabander N, Wojciechowski M, DeDecker K, Weerdt AD, Jorens PG. Fomepizole as a therapeutic strategy in pediatric methanol poisoning. A case report and rewiev of the literature. Eur J Pediatr 2005; 16: 158-161.
• Megarbone B, Borron SW, Baud FJ. Current recommendations for treatment of severe toxic alcohol poisonings. Intensive Care Med 2005; 31: 189-195
• Bestic M, Blackford M, Reed M. Fomepizole: a critical assessment of current dosing recommendations. J Clin Pharmacol 2009; 49: 130-137.