Drugs may be Induced Methemoglobinemia

Alanazi, Menyfah Q

doi:10.4172/2329-8790.1000270

Cited by 29 publications

(38 citation statements)

References 9 publications

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“…Acalypha indica is composed of various phytochemicals (Table 3) and nutrients which most of them play a role in human therapeutic property. 1 On the other hand, previous studies have implicated three constituents found in leaf and the whole parts of this plant; quinine, 15 2-methyl anthraquinone and tectoquinone 16 resulting in methemoglobinemia (Table 3). These constituents might have oxidative potentials.…”

Section: Discussionmentioning

confidence: 89%

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Clinical Characteristics of Acalypha indica Poisoning

Pradoo

Sriapha

Trakulsrichai

et al. 2020

IJGM

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Background: Acalypha indica is a tropical plant used as a herbal medicine in various parts of the world, including Thailand. In glucose-6-phosphate dehydrogenase (G6PD)-deficient patients, acute hemolysis has been reported following the ingestion of this plant. Methemoglobinemia was reported in the present study. Patients and Methods: Descriptive data of patients who suffered from Acalypha indica toxicity reported from different hospitals to the Ramathibodi Poison Center were retrieved from 2011 to 2019. Results: Eight patients were included, mostly male with a median age of 61.5 years. The plant was ground for fresh juice or boiled before consuming as herbal medicine. All patients presented with dark urine. Most had jaundice and fever, and all reported hemolysis. Seven out of eight patients were diagnosed as methemoglobinemia. Methemoglobin level was confirmed in five patients with the highest level of 23.9%. Early symptoms occurred within 24 hours of the last ingested dose. Discussion: In previous case reports of Acalypha indica ingestion, acute hemolysis was mostly observed in G6PD-deficient patients, consistent with the current findings. However, our patients also demonstrated methemoglobinemia, with some constituents in this plant (quinine, 2-methyl anthraquinone and tectoquinone) implicated as the cause in previous studies. Further studies are crucial to validate these findings. Conclusion: We report a case series in which acute hemolysis and methemoglobinemia after Acalypha indica ingestion were observed. This study presents methemoglobinemia as the other toxicity caused by this plant.

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Section: Discussionmentioning

confidence: 89%

“…Oxidative chemicals may cause both acute hemolysis and methemoglobinemia. [15][16][17] Although this plant contains cyanogenic glycosides and hydrogen cyanide, no patient developed or demonstrated any signs/symptoms of cyanide poisoning.…”

Section: Discussionmentioning

confidence: 99%

Clinical Characteristics of Acalypha indica Poisoning

Pradoo

Sriapha

Trakulsrichai

et al. 2020

IJGM

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“…Overall, however, the majority of cases of methemoglobinemia are due to exposure to medications and others toxic agents [4,11]. Common agents implicated in causing methemoglobinemia are listed in Table 1 [15].…”

Section: Risk Factors For Methemoglobinemiamentioning

confidence: 99%

Methemoglobinemia in the Operating Room and Intensive Care Unit: Early Recognition, Pathophysiology, and Management

et al. 2020

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The objectives of this review are to describe the acquired and hereditary causes of methemoglobinemia, to recommend the most sensitive diagnostic tests, and to enable critical care clinicians to rapidly detect and treat methemoglobinemia. To meet these objectives, Internet search engines were queried with the keywords to select articles for review that included case reports, case series, observational, longitudinal, and surveillance studies. The most common causes of methemoglobinemia include oxidizing reactions to cocaine-derived anesthetics, such as benzocaine and lidocaine, to antibiotics, such as dapsone and other sulfonamides, and to gases, such as nitric oxide. Additionally, CO-oximetry is superior to standard pulse oximetry in detecting methemoglobinemia. Finally, effective treatments for methemoglobinemia include intravenous administration of methylene blue, ascorbic acid, and riboflavin. In this manuscript we will discuss methemoglobinemia, how it occurs, and how to treat it.

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“…[1][2][3] Si bien la metahemoglobinemia puede ser hereditaria, la forma más común es la adquirida y se debe a la exposición a agentes oxidantes: medicamentos, antisépticos, pesticidas, colorantes y fertilizantes, además de otros agentes. [3][4][5][6][7]…”

Section: Introductionunclassified

Metahemoglobinemia por fenazopiridina: reporte de un caso con enfoque diagnóstico

2018

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INTRODUCCIÓN: La metahemoglobinemia adquirida es un trastorno en el que la hemoglobina es oxidada por un agente externo, impidiendo el transporte y entrega del oxígeno a los tejidos. Uno de los agentes oxidantes es el clorhidrato de fenazopiridina, una anilina con efecto analgésico empleada para tratar el dolor de la vía urinaria baja.CASO CLÍNICO: Paciente de 12 años, que ingirió 250 mg de amitriptilina, 1.8 g de fenazopiridina y 14.5 mg de clonazepam en un intento suicida, desarrollando metahemoglobinemia que requirió el empleo de azul de metileno en dos ocasiones.CONCLUSIONES: La metahemoglobinemia es subdiagnosticada a pesar de poder originar complicaciones graves e, incluso, la muerte. Se diagnostica mediante cooximetría. Cuando ésta no está disponible, además de los datos clínicos, debe evaluarse la brecha de saturación y la sangre color “chocolate”.PALABRAS CLAVE: Metahemoglobinemia; hemoglobina; oxígeno; agentes oxidantes; fenazopiridina; azul de metileno.

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Drugs may be Induced Methemoglobinemia

Cited by 29 publications

References 9 publications

<p>Clinical Characteristics of <em>Acalypha indica</em> Poisoning</p>

<p>Clinical Characteristics of <em>Acalypha indica</em> Poisoning</p>

Methemoglobinemia in the Operating Room and Intensive Care Unit: Early Recognition, Pathophysiology, and Management

Metahemoglobinemia por fenazopiridina: reporte de un caso con enfoque diagnóstico

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