**Core Concept**
Methyl alcohol (methanol) poisoning occurs when methanol is ingested, inhaled, or absorbed through the skin, leading to the formation of toxic metabolites that can cause neurological damage, visual impairment, and even death. The primary metabolic pathway involves the enzyme alcohol dehydrogenase (ADH), which converts methanol to formaldehyde, which is then converted to formic acid by aldehyde dehydrogenase.

**Why the Correct Answer is Right**
The correct treatment for methanol poisoning involves administering a competitive inhibitor of alcohol dehydrogenase, which reduces the formation of toxic metabolites. Fomepizole (4-methylpyrazole) is a specific inhibitor of ADH that is used to treat methanol poisoning. It works by competitively binding to the ADH enzyme, thereby reducing the conversion of methanol to formaldehyde and subsequent formation of formic acid.

**Why Each Wrong Option is Incorrect**
**Option A:** Ethanol is not a suitable treatment for methanol poisoning, as it can actually increase the formation of toxic metabolites by competing for ADH binding sites and increasing the production of formaldehyde.
**Option B:** Hemodialysis is a supportive treatment for methanol poisoning, but it does not address the underlying metabolic pathway and is not a primary treatment.
**Option C:** Activated charcoal may be used to treat acute methanol ingestion, but it does not address the metabolic conversion of methanol to toxic metabolites and is not a primary treatment.

**Clinical Pearl / High-Yield Fact**
In cases of suspected methanol poisoning, prompt administration of fomepizole and supportive care (including hemodialysis) is crucial to prevent neurological damage and visual impairment.

**Correct Answer: D. Fomepizole. Fomepizole is a competitive inhibitor of alcohol dehydrogenase that is used to treat methanol poisoning.**