ADH substrate
Alcohol dehydrogenase substrate (toxic alcohol)
- Competes for alcohol dehydrogenase → metabolized to toxic products (formate; glycolate/oxalate)
- Metabolites, not the parent alcohol, cause acidosis
- Formate → blindness
- Oxalate → renal failure
- ADH blockade is the antidote step
Drugs with this mechanism (2)
- Ethylene glycol — Toxic alcohol; oxalate causes the renal failure.
- Methanol — Toxic alcohol; formate causes the blindness, not methanol itself.
Self-check
- Which toxic alcohol metabolite causes blindness?
Formate. - Which toxic alcohol metabolite causes renal failure?
Oxalate.
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