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Hematology Reports May 2023Methemoglobinemia is an acute medical emergency that requires prompt correction. Physicians should have a high degree of suspicion of methemoglobinemia in cases that...
Phenazopyridine-Induced Methemoglobinemia in a Jehovah's Witness Treated with High-Dose Ascorbic Acid Due to Methylene Blue Contradictions: A Case Report and Review of the Literature.
Methemoglobinemia is an acute medical emergency that requires prompt correction. Physicians should have a high degree of suspicion of methemoglobinemia in cases that present with hypoxemia that does not resolve with supplemental oxygenation, and they should confirm this suspicion with a positive methemoglobin concentration on arterial blood gas. There are multiple medications that can induce methemoglobinemia, such as local anesthetics, antimalarials, and dapsone. Phenazopyridine is an azo dye used over-the-counter as a urinary analgesic for women with urinary tract infections, and it has also been implicated in causing methemoglobinemia. The preferred treatment of methemoglobinemia is methylene blue, but its use is contraindicated for patients with glucose-6-phosphatase deficiency or those who take serotonergic drugs. Alternative treatments include high-dose ascorbic acid, exchange transfusion therapy, and hyperbaric oxygenation. The authors report a case of a 39-year-old female who took phenazopyridine for 2 weeks to treat dysuria from a urinary tract infection and subsequently developed methemoglobinemia. The patient had contraindications for the use of methylene blue and was therefore treated with high-dose ascorbic acid. The authors hope that this interesting case promotes further research into the utilization of high-dose ascorbic acid for managing methemoglobinemia in patients who are unable to receive methylene blue.
PubMed: 37367083
DOI: 10.3390/hematolrep15020034 -
Ultrasonics Sonochemistry Jan 2016Pure and samarium doped ZnO nanoparticles were synthesized by a sonochemical method and characterized by TEM, SEM, EDX, XRD, Pl, and DRS techniques. The average...
Pure and samarium doped ZnO nanoparticles were synthesized by a sonochemical method and characterized by TEM, SEM, EDX, XRD, Pl, and DRS techniques. The average crystallite size of pure and Sm-doped ZnO nanoparticles was about 20 nm. The sonocatalytic activity of pure and Sm-doped ZnO nanoparticles was considered toward degradation of phenazopyridine as a model organic contaminant. The Sm-doped ZnO nanoparticles with Sm concentration of 0.4 mol% indicated a higher sonocatalytic activity (59%) than the pure ZnO (51%) and other Sm-doped ZnO nanoparticles. It was believed that Sm(3+) ion with optimal concentration (0.4 mol%) can act as superficial trapping for electrons in the conduction band of ZnO and delayed the recombination of charge carriers. The influence of the nature and concentration of various oxidants, including periodate, hydrogen peroxide, peroxymonosulfate, and peroxydisulfate on the sonocatalytic activity of Sm-doped ZnO nanoparticles was studied. The influence of the oxidants concentration (0.2-1.4 g L(-1)) on the degradation rate was established by the 3D response surface and the 2D contour plots. The results demonstrated that the utilizing of oxidants in combination with Sm-doped ZnO resulting in rapid removal of contaminant, which can be referable to a dual role of oxidants; (i) scavenging the generated electrons in the conduction band of ZnO and (ii) creating highly reactive radical species under ultrasonic irradiation. It was found that the Sm-doped ZnO and periodate combination is the most efficient catalytic system under ultrasonic irradiation.
PubMed: 26384896
DOI: 10.1016/j.ultsonch.2015.07.012 -
Journal of Community Hospital Internal... 2023Glucose-6-phosphate dehydrogenase (G6PD) deficiency is an X-linked recessive genetic disorder which commonly affects males. It is due to a defect in the red blood cell...
Syncope Following Treatment of UTI: A Case of Acute Hemolytic Anemia, Methemoglobinemia and Acute Renal Dysfunction Following Phenazopyridine Use in a Patient With G6PD Deficiency.
Glucose-6-phosphate dehydrogenase (G6PD) deficiency is an X-linked recessive genetic disorder which commonly affects males. It is due to a defect in the red blood cell enzyme, G6PD. Lack of G6PD makes the RBCs vulnerable to oxidant stress resulting in hemolysis. The severity of hemolytic anemia varies among individuals with G6PD deficiency. Here we present a case of an 80-year-old man admitted with syncope and jaundice. He was treated with phenazopyridine for a UTI 2 weeks ago. Subsequent investigation revealed G6PD deficiency as well as methemoglobinemia. Historically, phenazopyridine has been associated with causing methemoglobinemia and triggering hemolysis in G6PD deficient individuals. However, only a few cases have been reported in the last 60 years, making it a very rare occurrence.
PubMed: 36817304
DOI: 10.55729/2000-9666.1144 -
Urology Dec 2000To evaluate the frequency and types of treatments reported at baseline in women who entered the Interstitial Cystitis Data Base (ICDB) cohort study.
OBJECTIVES
To evaluate the frequency and types of treatments reported at baseline in women who entered the Interstitial Cystitis Data Base (ICDB) cohort study.
METHODS
From 1993 to 1997, 581 women were enrolled and followed in the ICDB. All treatments reported at study entry, including those prescribed for interstitial cystitis (IC) and concomitant medications, were reviewed. The number and types of treatments were evaluated with respect to baseline factors such as prior diagnosis of IC and symptom severity.
RESULTS
One hundred five (18%) women were receiving no therapy at baseline. Single-mode therapy was reported by 195 (34%) women, and a combination of two treatments was reported by 119 (21%) women. Three or more treatments were reported in 162 (28%) women. A total of 183 different types of therapies were recorded. The five most commonly used therapies for IC symptoms were cystoscopy and hydrodistention, amitriptyline, phenazopyridine, special diet, and intravesical heparin. Because most patients entered the ICDB before the approval of oral pentosan polysulfate sodium (PPS), only 6% of women reported oral PPS use at baseline. There were statistically significant associations between the number and types of treatments and clinical center, a prior diagnosis of IC, and symptom severity.
CONCLUSIONS
The diversity of IC therapies underscores the lack of understanding about the treatment of this syndrome. Further research in IC is essential to develop and to evaluate rational therapies and treatment algorithms. These algorithms should be "evidence based" and should be revised as the underlying etiology and pathophysiology of IC is delineated.
Topics: Amitriptyline; Cohort Studies; Cystitis, Interstitial; Cystoscopy; Dilatation; Female; Food, Formulated; Heparin; Humans; Male; Phenazopyridine; Treatment Outcome
PubMed: 11113737
DOI: 10.1016/s0090-4295(00)00845-1 -
Canadian Family Physician Medecin de... Jun 2008My pregnant patients often present with urinary tract infections. Are the medications commonly used for the management of urinary tract infections safe to use during...
QUESTION
My pregnant patients often present with urinary tract infections. Are the medications commonly used for the management of urinary tract infections safe to use during pregnancy?
ANSWER
Existing data indicate that exposure to penicillins, cephalosporins, fluoroquinolones, nitrofurantoin, or phenazopyridine during pregnancy is not associated with increased risk of fetal malformations. Trimethoprim-sulfamethoxazole should be avoided, if possible, during the first trimester of pregnancy because of the antifolate effect associated with neural tube defects.
Topics: Anti-Infective Agents, Urinary; Female; Humans; Pregnancy; Pregnancy Complications, Infectious; Urinary Tract Infections
PubMed: 18556490
DOI: No ID Found -
Blood Aug 1985The mechanism of drug-dependent immunologic thrombocytopenic purpura (DITP) was investigated by studying the sera of four patients with classic DITP (two with...
The mechanism of drug-dependent immunologic thrombocytopenic purpura (DITP) was investigated by studying the sera of four patients with classic DITP (two with quinidine-, one with acetaminophen-, and one with phenazopyridine-dependent antiplatelet antibody) using a solid-phase radioimmunoassay with 125I-staphylococcal protein A. Two forms of antiplatelet antibody could be demonstrated: one that required drug to bind to platelets and one that bound to platelets in the absence of drug. Drug-dependent antiplatelet antibody required the simultaneous addition of drug and the Fc domain of the drug-dependent IgG molecule for binding to platelets. It did not require serum complement or factor VIII-related antigen for binding to platelets. Drug-dependent binding of antibody to platelets was saturation-dependent. Non-drug-dependent antiplatelet antibody of two patients (one with quinidine-induced thrombocytopenia and the other with acetaminophen-induced thrombocytopenia) reacted with autologous platelets as well as with homologous platelets, indicating that they were autoantibodies. Both autoantibodies had disappeared when their sera were tested 23 and 138 days, respectively, after withdrawal of their initial positive sera. Non-drug-dependent antiplatelet antibody binding could be demonstrated with the F(ab')2 fragment of the purified IgG of the serum of the second patient with quinidine DITP, who did not have detectable alloantibodies against HLA. None of the four patients with non-drug-dependent antiplatelet antibody had a past or present history of autoimmune thrombocytopenic purpura.
Topics: Acetaminophen; Antibodies; Antigen-Antibody Complex; Autoimmune Diseases; Binding Sites, Antibody; Blood Platelets; Globulins; Humans; Immunoglobulin Fab Fragments; Immunoglobulin G; Phenazopyridine; Purpura, Thrombocytopenic; Quinidine; Radioimmunoassay
PubMed: 4040409
DOI: No ID Found -
Pain Research and Treatment 2011Objective. To compare Visual Analogue Scale (VAS) scores with overall postoperative pain medication requirements including cumulative dose and patterns of medication...
Objective. To compare Visual Analogue Scale (VAS) scores with overall postoperative pain medication requirements including cumulative dose and patterns of medication utilization and to determine whether VAS scores predict pain medication utilization. Methods. VAS scores and pain medication data were collected from participants in a randomized trial of the utility of phenazopyridine for improved pain control following gynecologic surgery. Results. The mean age of the 219 participants was 54 (range19 to 94). We did not detect any association between VAS and pain medication utilization for patient-controlled anesthesia (PCA) or RN administered (intravenous or oral) medications. We also did not detect any association between the number of VAS scores recorded and mean pain scores. Conclusion. Postoperative VAS scores do not predict pain medication use in catheterized women inpatients following gynecologic surgery. Increased pain severity, as reflected by higher VAS scores, is not associated with an increase in pain assessment. Our findings suggest that VAS scores are of limited utility for optimal pain control. Alternative or complimentary methods may improve pain management.
PubMed: 22110938
DOI: 10.1155/2011/987468 -
Frontiers in Chemistry 2021Nanosized titanium oxide (TiO)-based photocatalysts have exhibited great potential for the degradation of organic contaminants, while their weak absorption of visible...
Preparation and Characterization of Reduced Graphene Oxide /TiO Blended Polyphenylene sulfone Antifouling Composite Membrane With Improved Photocatalytic Degradation Performance.
Nanosized titanium oxide (TiO)-based photocatalysts have exhibited great potential for the degradation of organic contaminants, while their weak absorption of visible light limits the photocatalytic efficiency. Herein, a novel reduced graphene oxide/TiO-polyphenylenesulfone (rGO/TiO-PPSU) hybrid ultrafiltration membrane has been successfully prepared via a non-solvent induced phase-separation method, in which the synergistic coupling between the rGO and TiO could endowed the fabricated membranes with visible-light-driven efficient photocatalytically degradation of organic pollutants and outstanding photocatalytic and antifouling properties. Compared with the PPSU membranes prepared with Graphene oxide and TiO, respectively, the rGO/TiO-PPSU membrane demonstrated significant photodegradation towards phenazopyridine hydrochloride (PhP) solution under ultraviolet light (improved about 71 and 43%) and visible light (improved about 153 and 103%). The permeability and flux recovery rates of the membrane indicated that the high flux of the rGO/TiO-PPSU membrane can be greatly restored after fouling, due to the improved self-cleaning properties under visible light static irradiation. With the properties of high performance of photocatalytic degradation and good self-cleaning ability, the rGO/TiO-PPSU membrane would have great potential in water treatment.
PubMed: 34738005
DOI: 10.3389/fchem.2021.753741 -
Canadian Medical Association Journal Oct 1964
Topics: Anemia; Anemia, Hemolytic; Anti-Infective Agents, Local; Blood Transfusion; Geriatrics; Glucosephosphate Dehydrogenase Deficiency; Glucosephosphates; Phenazopyridine; Toxicology; Urinary Tract Infections
PubMed: 14215217
DOI: No ID Found -
Journal of Applied Behavior Analysis 1978This study examined the effectiveness of several behavioral techniques on compliance of college students taking vitamin C on q.i.d. regimen. Compliance was assessed by a...
This study examined the effectiveness of several behavioral techniques on compliance of college students taking vitamin C on q.i.d. regimen. Compliance was assessed by a new technique using a variation of the urine tracer procedure designed specifically for this study. Subjects were provided vitamin C tablets, with three tablets per week containing phenazopyridine, a drug that produces a bright red-orange urine discoloration. Subjects were requested to indicate when urine discolorations occurred, and compliance was assessed by comparing the time of their report to the time predicted on the basis of the scheduled sequence of vitamin C and phenazopyridine tablets. Baseline compliance was assessed for 72 subjects over a three-week period, with the 40 most noncompliant subjects randomly assigned to four groups for Treatment I. The groups were: self-monitoring, taste, taste and self-monitoring, and a no-treatment control group. The self-monitoring procedure involved recording the time medicine was taken; the taste procedure involved providing the subjects with flavored tablets to increase the saliency of tablet taking; and the self-monitoring and taste procedure involved providing subjects with flavored tablets and asking them to record the flavor of each tablet they ingested. At the end of six weeks, half the subjects in each of these groups participated in response-cost procedures while the remaining subjects continued with their previous procedures. Response-cost procedures were implemented by returning a portion of the subjects' deposit only if a preset compliance criterion was met. Treatment II procedures were implemented for an additional three weeks. Results indicated the self-monitoring and taste plus self-monitoring procedures were superior during Treatment I. The implementation of response cost during Treatment II was associated with a marked improvement in compliance, independent of the history of noncompliance. The effects of the taste plus self-monitoring procedure were maintained during Treatment II and results obtained by this procedure were not significantly different from effects of response cost.
Topics: Ascorbic Acid; Behavior Therapy; Common Cold; Flavoring Agents; Humans; Patient Compliance; Phenazopyridine; Reinforcement, Psychology; Self-Assessment
PubMed: 649520
DOI: 10.1901/jaba.1978.11-1