SN + acetominophen + benzocaine = Methemoglobinemia

[angrywarhol2021]

We know that SN causes death by Methemoglobinemia. Also, benzocaine can cause methemoglobinemia. Acetaminophen can also cause MG.

One their own, its probably not feasible or effective to consume enough benzocaine or acetaminophen to produce a lethal MG. But would taking SN + benzocaine + ibuprofen together increase the potency of the SN and increase the probability of success?

Some links for reference:

Methemoglobinemia associated with massive acetaminophen ingestion: a case series - PubMed

<span><b>Background:</b> Acetaminophen is a common pharmaceutical ingestion reported to US poison centers. In overdose, toxic metabolites are known to cause hepato- and nephrotoxicity. While G6PD deficiency may be a risk factor for methemoglobin production in the setting of acetaminophen...

pubmed.ncbi.nlm.nih.gov

Benzocaine-induced methemoglobinemia based on the Mayo Clinic experience from 28 478 transesophageal echocardiograms: incidence, outcomes, and predisposing factors - PubMed

In a large series of patients undergoing TEE, the incidence of methemoglobinemia is low (1 case per 1499 [0.067%; 95% confidence interval, 0.040%-0.100%]) and has a good outcome if promptly recognized and treated. Clinical factors associated with the development of methemoglobinemia include...

pubmed.ncbi.nlm.nih.gov

https://paininjuryrelief.com/wp-content/uploads/2012/08/Anesth-Analg-2000-Nguyen-369.pdf

Acetaminophen-associated methemoglobinemia - PubMed

Acetaminophen-associated methemoglobinemia

pubmed.ncbi.nlm.nih.gov

Benzocaine and lidocaine induced methemoglobinemia after bronchoscopy: a case report

Methemoglobinemia is a rare cause of hypoxemia, characterized by abnormal levels of oxidized hemoglobin that cannot bind to and transport oxygen.A 62-year-old male underwent bronchoscopy where lidocaine oral solution and Hurricaine spray (20% benzocaine) ...

www.ncbi.nlm.nih.gov

Methemoglobin

Systematic review of methemoglobinemia in acetaminophen poisoning

Summary . Acetaminophen (N-acetyl-p-aminophenol paracetamol (APAP)) toxicity is one of the commonly encountered poisonings by emergency physicians. Methemo

academic.oup.com

Evaluation and management of acquired methemoglobinemia associated with topical benzocaine use - PubMed

Benzocaine is a widely used topical oropharyngeal anesthetic and has been reported to cause methemoglobinemia. We discuss benzocaine-induced methemoglobinemia and review the causes, presentation, and management of this serious complication. Treatment with methylene blue will result in reversal...

pubmed.ncbi.nlm.nih.gov

 

[wereqryan]

But would taking SN + benzocaine + ibuprofen together increase the potency of the SN and increase the probability of success?

Do these drugs interact with each other in a way that reduces their potency? That's the worry.

 

[Nolen]

But the potency of the SN isn't really decided on If it "can" but rather "when" it's stimulating Methemoglobinemia in the body due to how much is absorbed. I don't really see the need for other drugs here since you already consume a very large and lethal dose of the SN, far more than is necessary, to guarantee enough absorption even If you might vomit and I think adding anything onto that might increase the risk. And why the Iburpofen? Since Acetaminophen is paracetamol.

 

[Chisel]

Apparently Sodium bicarb increases SN potency. A tbs full before SN is all you need.

 

[angrywarhol2021]

But the potency of the SN isn't really decided on If it "can" but rather "when" it's stimulating Methemoglobinemia in the body due to how much is absorbed. I don't really see the need for other drugs here since you already consume a very large and lethal dose of the SN, far more than is necessary, to guarantee enough absorption even If you might vomit and I think adding anything onto that might increase the risk. And why the Iburpofen? Since Acetaminophen is paracetamol.

Tylenol is the common US brand for acetaminophen.