Circulus hypoxicus

The result of formate accumulation is metabolic acidosis. However, at later stages, the acidosis may also involve the accumulation of other anions such as lactate. This may be a result of inhibition of cytochrome oxidase and hence of mitochondrial respiration, tissue hypoxia due to reduced circulation of blood, or an increase in the NADH/NAD ratio. The acidosis that results from methanol poisoning will result in more formic acid being in the nonionized state and hence more readily able to enter the CNS. This will cause central depression and hypotension and increased lactate production. This situation is known as the "circulus hypoxicus."... 

Methanol is a solvent, which is added to ethanol and sometimes used in antifreeze. The main target organ is the optic system resulting from metabolic inhibition and systemic toxicity due to metabolic acidosis from formate and lactate. Toxicity is due to metabolism to formic acid via alcohol dehydrogenase and insufficient detoxication via tetrahydrofolate. The overall result is circulus hypoxicus. Treatment involves blockade of metabolism with ethanol and treatment of metabolic acidosis (NaHCC>3). 

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See also in sourсe #XX -- [ ]

See also in sourсe #XX -- [ ]

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