Incidence of metoclopramide-induced methemoglobinemia

Drug-induced methemoglobinemia.

The normal presentation of a patient with a drug induced methemoglobinemia is a low pulse oximetry (SpO2) reading, usually in the mid 80% range, while having a very high PaO2 on an arterial blood gas (ABG)1. We present a case where the initial ABG showed a very high PaO2 and a metabolic alkalosis while the SpO2 fluctuated (85% 99%). Those findings combined with hemodynamic instability complicat...

Benzocaine-induced methemoglobinemia.

A case is reported in which a patient developed methemoglobinemia-induced cyanosis while under general anesthesia during surgery for multiple fascial space infections. The cause of methemoglobinemia was 20% benzocaine spray used for local anesthesia before intubation. Acutely developing methemoglobinemia is infrequently encountered in clinical practice. When confronted with cyanosis in the abse...

Methemoglobinemia induced by chlorphenamidine.

A 76-year old farmer ingested 100 g of chlorphenamidine (Galectron), a plant acaricle, for the purpose of suicide. Gastric lavage was performed and the patient survived. Methemoglobinemia was noted after emergency treatment and was still present at 20 hours after ingestion of the compound. The patient was lethargic for at least 50 hours. Moderate neutrophilic leukocytosis and kidney injury were...

Prilocaine-induced Methemoglobinemia.

Metoclopramide-induced cardiac arrest

The authors report a case of cardiac arrest in a patient receiving intravenous (IV) metoclopramide and review the pertinent literature. A 62-year-old morbidly obese female admitted for a gastric sleeve procedure, developed cardiac arrest within one minute of receiving metoclopramide 10 mg via slow intravenous (IV) injection. Bradycardia at 4 beats/min immediately appeared, progressing rapidly t...