Case presentation A 17-year old Sri Lankan male (body weight – 42 kg), presented to a local hospital 1 hour after self-ingestion of nearly 500 ml (4.3 g/kg) of liquid Propanil (concentration – 360 g/l). [bmcresnotes.biomedcentral.com]

Above 70% of this depletion, the reactive N-acetylimidoquinone metabolite will begin to react with nucleophilic thiol (-SH) groups that are present on hepatic and renal proteins. [pharmaxchange.info]

See Clues on the Skin: Acute Poisonings, a Critical Images slideshow, to help diagnose patients based on their dermatologic presentations. [emedicine.medscape.com]

First Aid EYES: First check the victim for contact lenses and remove if present. Flush victim's eyes with water or normal saline solution for 20 to 30 minutes while simultaneously calling a hospital or poison control center. [cameochemicals.noaa.gov]

If oil particles (e.g. lubricants, cutting fluids, glycerine, etc.) are present, use a NIOSH type R or P filter. For emergencies or instances where the exposure levels are not known, use a full-face positive-pressure, air-supplied respirator. [nilechemicals.com]

• Anemia

  In experiments on two dogs the first effect of daily acetanilid ingestion was an anemia. Following prolonged administration the animals gained tolerance. [jpet.aspetjournals.org]

  These aniline derivatives can cause methemoglobinemia and hemolytic anemia. [pharmaxchange.info]

  For patient education resources, see Anemia. [emedicine.medscape.com]

  Chronic poisoning by acetanilide may lead to anemia & sulfhemoglobinemia, with discoloration evident in conjunctival & retinal vessels. Drug Warnings: 1. Acetanilide is especially dangerous in anemia, after hemorrhage and during menstruation. 2. [slideshare.net]

  (NTP, 1992) Health Hazard SYMPTOMS: Symptoms of exposure to this compound may include contact dermatitis and eczematous skin eruptions; anemia and cyanosis. ACUTE/CHRONIC HAZARDS: This compound is an irritant. [cameochemicals.noaa.gov]

• Weakness

  Amides are very weak bases (weaker than water). Imides are less basic yet and in fact react with strong bases to form salts. That is, they can react as acids. [cameochemicals.noaa.gov]

  In example, one out of the 19 persons in the main study showed a weak response to aniline only (‘non-responder’) in terms of a baseline level of 0.93 prior to exposure and a maximum observed saturation level of 1.0% at the end of exposure thus resulting [echa.europa.eu]

  Mild poisoning with acetanilide causes headache, weakness, hypotension, nausea & vomiting & with more severe poisoning there is depression of cardiac & smooth muscle. 5. [slideshare.net]

  […] associated with higher levels of methemoglobin are as follows: 3-15% - Slight discoloration (eg, pale, gray, blue) of the skin 15-20% - Cyanosis, though patients may be relatively asymptomatic 25-50% - Headache, dyspnea, lightheadedness (even syncope), weakness [emedicine.medscape.com]

• Unconsciousness

  One should never give anything by mouth if the victim is unconscious. Immediate medical assistance is important. [chemistrylearner.com]

  If the victim is convulsing or unconscious, do not give anything by mouth, ensure that the victim's airway is open and lay the victim on his/her side with the head lower than the body. DO NOT INDUCE VOMITING. [cameochemicals.noaa.gov]

  Never give anything by mouth to an unconscious person. Get medical attention. Skin Contact: Immediately flush skin with plenty of water for at least 15 minutes. Remove contaminated clothing and shoes. Get medical attention. [nilechemicals.com]

• Gastric Lavage

  However gastric lavage was not done and activated charcoal was not given. Subsequently, the patient developed marked respiratory difficulty, central and peripheral cyanosis and drowsiness. [bmcresnotes.biomedcentral.com]

• Weight Loss

  […] another potential dietary cause of methemoglobinemia. [35] Other substances that can cause methemoglobinemia include the following: Copper sulfate Organic compounds – Sodium chlorite, [36] ammonium carbonate (smelling salts), [37] and 2,4-dinitrophenol (weight [emedicine.medscape.com]

• Cough

  If symptoms (such as wheezing, coughing, shortness of breath, or burning in the mouth, throat, or chest) develop, call a physician and be prepared to transport the victim to a hospital. [cameochemicals.noaa.gov]

• Vomiting

  DO NOT INDUCE VOMITING. IMMEDIATELY transport the victim to a hospital. [cameochemicals.noaa.gov]

  Contact your doctor or emergency room at once if you develop severe stomach or back pain; black, tarry stools; vomit that looks like blood or coffee grounds; or unusual weight gain or swelling. [sale-meds.com]

  Mild poisoning with acetanilide causes headache, weakness, hypotension, nausea & vomiting & with more severe poisoning there is depression of cardiac & smooth muscle. 5. [slideshare.net]

  Ingestion: It is not advisable to induce vomiting without proper direction from a qualified physician. Any tight clothing like tie, collar and waistband should be loosened. One should never give anything by mouth if the victim is unconscious. [chemistrylearner.com]

• Nausea

  Mild poisoning with acetanilide causes headache, weakness, hypotension, nausea & vomiting & with more severe poisoning there is depression of cardiac & smooth muscle. 5. [slideshare.net]

  Anacin's side effects may include dizziness, heartburn, irritability, nausea, nervousness, rashes, hives, bloody stools, drowsiness, hearing loss, ringing in the ears, and trouble sleeping. [sale-meds.com]

  Clinical features include; gastrointestinal irritation causing abdominal pain, nausea and vomiting, central and peripheral cyanosis due to methaemoglobinaemia, headache, dizziness, stupor, convulsions, bradycardia, hypotension, respiratory depression, [bmcresnotes.biomedcentral.com]

• Blood in Stool

  Anacin may reduce the number of clot-forming cells (platelets) in your blood. To prevent bleeding, avoid situations in which bruising or injury may occur. Report any unusual bleeding, bruising, blood in stools, or dark, tarry stools to your doctor. [sale-meds.com]

• Hematochezia

  Haug Browse recently published Learning/CME Learning/CME View all learning/CME CME Partial Oral versus Intravenous Antibiotic Treatment of Endocarditis Case 4-2019: An 18-Year-Old Man with Abdominal Pain and Hematochezia Bridging the Gap Challenge Yourself [nejm.org]

• Irritability

  […] acid, ethyl ester, Irritant benzoic acid C 6 H 5 CO 2 H S 122.12 122.4 Irritant benzoic acid, 4-acetamido CH 3 CONHC 6 H 4 CO 2 H S 179.18 256.5 Irritant benzoic acid, 4-amino NH 2 C 6 H 4 CO 2 H S 137.14 188-189 1.374 Irritant benzoic acid, 3-chloro [athabascau.ca]

  【Combustion Products】 Fire may produce irritating, corrosive and/or toxic gases. Company Name: J & K SCIENTIFIC LTD. [chemicalbook.com]

  IMMEDIATELY transport the victim after flushing eyes to a hospital even if no symptoms (such as redness or irritation) develop. SKIN: IMMEDIATELY flood affected skin with water while removing and isolating all contaminated clothing. [cameochemicals.noaa.gov]

  Skin Contact: Causes irritation to skin. Symptoms include redness, itching, and pain. Eye Contact: Causes irritation, redness, and pain. [nilechemicals.com]

  Toxicology Direct skin and eye contact will result in severe irritation. It can cause skin allergies and irritation of the respiratory tract. More serious effects may include blood abnormalities. [chemistrylearner.com]

• Excitement

  Find out more about this exciting new development through this step by step guide. [cabdirect.org]

  【Exposure Effects】 CNS excitation progressing to CNS depression is reported in fatally poisoned animals. [chemicalbook.com]

• Vertigo

  Symptoms of nausea & vomiting, vertigo & ringing in ears occur with large doses or in sensitive individuals with therapeutic doses. Sweating may be profuse. Large doses lead to mental confusion, muscular in coordination & coma. 3. [slideshare.net]

(See Workup.) The most important aspects of the management of methemoglobinemia are recognition of the condition and prompt initiation of treatment, when indicated. [emedicine.medscape.com]

Topics covered include chemical pollution of freshwater and marine environments, drinking water quality, water pollution biology, sewage and its treatment, toxic wastes, air pollution and atmospheric chemistry, control of pollutant emissions, land contamination [books.google.com]

The most important aspects of the management of methemoglobinemia are recognition of the condition and prompt initiation of treatment, when indicated. For mild asymptomatic cases, treatment is purely for cosmetic or psychological reasons. [emedicine.medscape.com]

Drug treatments / 002B02V Drug intoxications. [pascal-francis.inist.fr]

Treatment by administration of tolonium chloride (toluidine blue) resulted in complete recovery of the patient. [ncbi.nlm.nih.gov]

Winchester JF et al:Extracorporeal treatment of salcylate or acetaminophen poisoing: Is there a role? Arch Intern Med 141:370,1985. Doul J, Klaassen CD, Amdur MO: Casarett and Doull's Toxicology. 2nd ed.,Acetaminophen. [med.teikyo-u.ac.jp]

Prognosis The prognosis of mild cases of methemoglobinemia is very favorable. In severe cases, the prognosis is determined by the degree of anoxic end-organ damage. [emedicine.medscape.com]

The presence of anemia and cyanosis despite oxygen treatment results from both of these effects. [4, 5] (See Pathophysiology and Etiology.) Methemoglobinemia occurs when red blood cells (RBCs) contain methemoglobin at levels higher than 1%. [emedicine.medscape.com]

PubMed View Article Google Scholar Wright RO, Lewander WJ, Woolf AD: Methemoglobinemia: etiology, pharmacology, and clinical management. Ann Emerg Med. 1999, 34 (5): 646-656. 10.1016/S0196-0644(99)70167-8. [bmcresnotes.biomedcentral.com]

Epidemiology of nonsteroidal anti-inflammatory drug-associated gastrointestinal injury. Am J Med 1998;104:23s-29s. Google Scholar Dajani EZ, Agrawal NM. Prevention and treatment of ulcers induced by nonsteroidal anti-inflammatory drugs: An update. [link.springer.com]

Indigo carmine Resorcinol Metoclopramide [50] Antibiotics – Sulfonamides, nitrofurans, and para-aminosalicylic acid Industrial/household agents – Aniline dyes, nitrobenzene, naphthalene (moth balls), aminophenol, and nitroethane (nail polish remover) Epidemiology [emedicine.medscape.com]

Pathophysiology RBCs contain hemoglobin, which has a quaternary structure. Each hemoglobin molecule is composed of 4 polypeptide chains. [emedicine.medscape.com]

Skin Protection: Wear impervious protective clothing, including boots, gloves, lab coat, apron or coveralls, as appropriate, to prevent skin contact. [nilechemicals.com]

There is a completely new chapter on Clean Technologies and Industrial Ecology, reflecting the growing importance of pollution prevention as opposed to end-of-pipe solutions.Whilst originally intended as an introductory reference work for professionals [books.google.com]

Prevention and treatment of ulcers induced by nonsteroidal anti-inflammatory drugs: An update. J Physiol Pharmacol 1995;46:3-16. Google Scholar Taha AS, Hudson N, Hawkey CJ et al. [link.springer.com]

You can help prevent errors by Knowing your medicines. When you get a prescription, ask the name of the medicine and check to make sure that the pharmacy gave you the right medicine. [icdlist.com]

Reduction of the amount of prostoglandin, therefore, helps prevent headaches and other pain. How it's made Paracetamol is one of the most common drugs used in the world, and is manufactured in huge quantities. [ch.ic.ac.uk]