Methemoglobinemia Produced by High-Dose Intravenous Nitroglycerin
Authors: GARY R. GIBSON
Journal: Annals of Internal Medicine (1982)

Brief Reports1 May 1982Methemoglobinemia Produced by High-Dose Intravenous NitroglycerinGARY R. GIBSON, M.D., J. BEATTY HUNTER, M.D., DANIEL S. RAABE Jr., M.D., DEBORAH L. MANJONEY, M.D., FRANK P. ITTLEMAN, M.D.GARY R. GIBSON, M.D., J. BEATTY HUNTER, M.D., DANIEL S. RAABE Jr., M.D., DEBORAH L. MANJONEY, M.D., FRANK P. ITTLEMAN, M.D.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-96-5-615 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe intravenous form of nitroglycerin has recently become available for general use. The ease of administration and well-documented efficacy of this agent in treating acute ischemic heart disease has led to its widespread use. Limitations on dosage of nitroglycerin have been related to its hemodynamic properties. Although the relation between certain nitrites and methemoglobinemia is well known, toxic doses of nitroglycerin have not been established. We report on the occurrence of methemoglobinemia, another reason for limiting the dose of nitroglycerin.A 58-year-old man was admitted to a local hospital with a subendocardial myocardial infarction. In the hospital he developed rest...References1. JAFFE E. Methaemoglobinaemia. Clin Haematol. 1981;10:99-122. CrossrefMedlineGoogle Scholar2. BEUTLER E. Methemoglobinemia and sulfhemoglobinemia. In: WILLIAMS WJ, BEUTLER E, ERSLEV AJ, RUNDLES RW, eds. Hematology. 2nd ed. New York: McGraw-Hill; 1977:491-4. Google Scholar3. BUNN H. Disorders of hemoglobin structure, function and synthesis. In: ISSELBACHER KJ, ADAMS RD, BRAUNWALD E, PETERSDORF RG, WILSON JD, eds. Harrison's Principles of Internal Medicine. 9th ed. New York: McGraw-Hill; 1980:1551-2. Google Scholar4. GEFFNER M, POWARS D, and CHOCTAW W. Acquired methemoglobinemia. West J Med. 1981;134:7-10. MedlineGoogle Scholar5. FIBUCH E, CECIL W, and REED W. Methemoglobinemia associated with organic nitrate therapy. Anesthesia and analgesia. 1979;58:521-3. CrossrefMedlineGoogle Scholar6. MARSHALL J and ECKLUND R. Methemoglobinemia from overdose of nitroglycerin. JAMA. 1980;244 :330. Letter. CrossrefMedlineGoogle Scholar7. BOWER P and PETERSON J. Methemoglobinemia after sodium nitroprusside therapy. N Engl J Med. 1976;293:865. CrossrefGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: GARY R. GIBSON, M.D.; J. BEATTY HUNTER, M.D.; DANIEL S. RAABEJr., M.D.; DEBORAH L. MANJONEY, M.D.; FRANK P. ITTLEMAN, M.D.Affiliations: Department of Medicine University of Vermont College of Medicine Burlington, Vermont PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byPreclusion of methemoglobinemia caused by nitrate drugs in diabetics and nondiabetics: Possible role of Vitamin CNeonatal ischemic limb lesions: From etiology to topical nitroglycerine. A case series analysisNitroglycerin Use in the Emergency Department: Current PerspectivesDo nitrates improve survival on acute heart failure?Pharmacologic Options for Treatment of Ischemic DiseaseTopical Nitroglycerine for Neonatal Arterial Associated Peripheral Ischemia following Cannulation: A Case Report and Comprehensive Literature ReviewCase Files of the Medical Toxicology Fellowship at Banner Good Samaritan Medical Center in Phoenix, AZ: Methemoglobinemia Following Dapsone ExposureMethemoglobinemiaOur contributions: scholarship revisitedVasodilators in the treatment of pediatric heart failureInfluence of Vasodilator Drugs on Perioperative Blood PressureExtreme methaemoglobinaemia secondary to recreational use of amyl nitrite.Methemoglobin levels during prolonged combined nitroglycerin and sodium nitroprusside infusions in infants after cardiac surgeryVasodilatorsMethemoglobinemia: An Occupational Hazard of Phenylpropanolamine ProductionToxic Methemoglobinemia Caused by Topical Anesthetic Given Before Transesophageal EchocardiographyNitroprusside, Nitroglycerin, and Angiotensin-Converting Enzyme InhibitorsOrganic Nitrate-Induced MethemoglobinemiaPostinfarction anginaNitrite-induced methaemoglobinaemiaMethemoglobinemia from Intravenous Nitroglycerin: A Word of CautionVasodilator therapy in the perioperative periodMethemoglobin levels following sublingual nitroglycerin in human volunteersAcute methemoglobinemia during cardiopulmonary bypass caused by intravenous nitroglycerin infusionEffects of continuous infusion of intravenous nitroglycerin on methemoglobin levelsVasoactive Drugs and the Failing VentricleOrganic NitratesAssociation of methemoglobinemia and intravenous nitroglycerin administrationIntravenous nitroglycerin: Clinical pharmacology and therapeutic considerationsMethemoglobin Levels Produced by Organic Nitrates in Patients with Coronary Artery DiseaseDifferences in the nitrite ion formation and the toxicological findings between isosorbide dinitrate and isosorbide-5-mononitrateNitroglycerin Dosage and Polyethylene TubingROBERT TUCKER, M.S., R.PH. 1 May 1982Volume 96, Issue 5Page: 615-616KeywordsCardiovascular therapyClinical pathologyHemodynamicsHospitalsMethemoglobinemiaMyocardial infarctionResearch laboratories ePublished: 1 December 2008 Issue Published: 1 May 1982 PDF downloadLoading ...