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You are seeing a child with suspected methemoglobinemia from overuse of benzocaine teething gel. You plan to treat with methylene blue. Which of the following past medical history conditions makes methylene blue a contraindicated treatment?
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June 7, 2019 at 10:46 pm
B) G6PD deficiency
Methylene blue helps reduce the oxidized hemoglobin of methemoglobinemia from Fe3+ back to the Fe2+ state. It is contraindicated in those with G6PD deficiency since it can set off hemolysis. It is also contraindicated in Heinz body anemia, in severe renal failure, and in those with a history of hypersensitivity to methylene blue. It may also cause serotonin syndrome when co-administered with serotonergic drugs such as SSRIs.