For methanol toxicity in severe cases, which intervention is indicated?

• A. Hemodialysis
• B. Activated charcoal
• C. Vitamin C
• D. Chest physiotherapy

Answer: (A)

In methanol poisoning, the danger comes from its metabolite formic acid, which causes severe metabolic acidosis and can damage the optic system. In severe cases, you need to rapidly remove methanol and formate from the blood and correct the acidosis. Hemodialysis does this most effectively: it quickly clears both methanol and formate and helps restore the pH and electrolytes, reducing ongoing tissue injury and preventing complications. Activated charcoal may help if the ingestion was very recent, but once severe toxicity is present, dialysis is the most reliable way to remove the toxin rapidly. Vitamin C and chest physiotherapy don’t address the main problem in methanol toxicity. Additional treatments include inhibitors of alcohol dehydrogenase (fomepizole or ethanol) and bicarbonate for acidosis, but dialysis is the key intervention in severe cases.