The case of a 3-week-old male infant is described. After receiving an iatrogenic overdose of metoclopramide (1.0 mg/kg every six hours) throughout a 36-hour period for the treatment of suspected gastroesophageal reflux, he became cyanotic, lethargic, and irritable, he fed poorly, and he had diarrhea and respiratory distress. Methemoglobinemia (20.5%) and reduced oxyhemoglobin saturation (79%) were identified. The patient had an excellent clinical response following a single IV dose of methylene blue. Subsequently, methemoglobin reductase activity was normal and there was no measurable hemoglobin M. The diagnosis of methemoglobinemia should be considered in any infant receiving large doses of metoclopramide who has clinical findings of cyanosis, ashen color, or a history of lethargy and/or motor restlessness.
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September 1988
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September 01 1988
Metoclopramide-Induced Methemoglobinemia
Gregory L. Kearns;
Gregory L. Kearns
From the Departments of Pharmaceutics, Pediatrics, and Anesthesiology, University of Arkansas for Medical Sciences, and the Division of Critical Care Medicine, Arkansas Children's Hospital, Little Rock
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Debra H. Fiser
Debra H. Fiser
From the Departments of Pharmaceutics, Pediatrics, and Anesthesiology, University of Arkansas for Medical Sciences, and the Division of Critical Care Medicine, Arkansas Children's Hospital, Little Rock
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Pediatrics (1988) 82 (3): 364–366.
Article history
Received:
May 07 1987
Accepted:
June 26 1987
Citation
Gregory L. Kearns, Debra H. Fiser; Metoclopramide-Induced Methemoglobinemia. Pediatrics September 1988; 82 (3): 364–366. 10.1542/peds.82.3.364
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