What treatment is indicated for suspected ethylene glycol poisoning?

• A. Administering activated charcoal
• B. Providing O2 therapy exclusively
• C. Administering fomepizole or ethanol as antidotes
• D. Performing surgery to remove the toxin

Answer: (C)

In cases of suspected ethylene glycol poisoning, the administration of fomepizole or ethanol serves as the primary treatment strategy. These substances act as competitive inhibitors of the enzyme alcohol dehydrogenase, which is responsible for metabolizing ethylene glycol into its toxic metabolites. By inhibiting this enzyme, fomepizole or ethanol helps to prevent the formation of harmful byproducts such as glycolic acid and oxalic acid, which can lead to metabolic acidosis and renal damage.

The use of fomepizole is particularly preferred because it is more effective and has fewer side effects compared to ethanol. Ethylene glycol itself is not directly harmful at the time of ingestion; rather, its harmful effects come from its metabolites. Thus, timely administration of these antidotes plays a crucial role in mitigating the toxicity of ethylene glycol.

The other treatment options mentioned are not effective for this specific type of poisoning. The administration of activated charcoal might be indicated in some poisoning scenarios if the patient presents soon after ingestion, but it is not the primary treatment for ethylene glycol due to the risk of delayed gastric emptying and its limited efficacy against the rapidly metabolized ethylene glycol. Oxygen therapy may be necessary for patients with respiratory distress but does not address the metabolic issues