Final answer:
The two main non-dialysis therapies for ethylene glycol intoxication are ethanol and fomepizole, which inhibit the alcohol dehydrogenase enzyme and prevent the formation of toxic metabolites.
Step-by-step explanation:
The two main therapies for ethylene glycol intoxication, other than dialysis, are the administration of ethanol or fomepizole. These substances work by inhibiting alcohol dehydrogenase, the enzyme responsible for metabolizing ethylene glycol into its toxic metabolites. Ethanol, being a competitive substrate for alcohol dehydrogenase, is used because it has a higher affinity for the enzyme, thus preventing the formation of toxic ethylene glycol metabolites. Fomepizole acts similarly but is a more potent inhibitor of alcohol dehydrogenase and does not produce intoxication.
The metabolism of ethylene glycol leads to the production of several toxic metabolites, such as glycolic acid, that can cause severe metabolic acidosis and organ damage, especially in the kidneys. By blocking the conversion of ethylene glycol to these harmful compounds, the aforementioned therapies help to prevent kidney damage, cerebral edema, and other potentially lethal effects.