Which enzyme does fomepizole inhibit in the treatment of methanol poisoning?

Fomepizole is specifically designed to inhibit alcohol dehydrogenase, the enzyme responsible for the conversion of methanol to its toxic metabolites, formaldehyde and formic acid. By blocking this enzyme, fomepizole effectively prevents the metabolism of methanol, allowing it to be excreted unchanged by the kidneys, thus reducing the risk of methanol poisoning and its lethal effects. This mechanism is particularly important in treating methanol toxicity, as the toxic metabolites are responsible for the severe metabolic acidosis and potential visual impairment associated with methanol ingestion. The focused action of fomepizole on alcohol dehydrogenase makes it a critical therapeutic agent in managing cases of methanol poisoning.