Methemoglobin formation in analgesic nephropathy

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Abstract
Three groups were investigated to determine whether methemoglobin formation is greater than normal in chronic phenacetin analgesic abusers. Group I (8 patients) was comprised of nonabusers with normal renal function; Group II (12 patients), of nonabusers with impaired renal function; Group III (9 patients), of abusers who had consumed phenacetin in combination with acetylsalicylic acid, caffeine, and codeine for 7 to 20 years, and had Similarly impaired renal function. Each subject was given 2 gm of phenacetin in a single dose, orally. Analysis of variance revealed significantly higher methemoglobin levels in Group III than in Groups I and II (p < 0.005). After cessation of analgesic abuse, there was a reduction in methemoglobin formation in 5 of 6 Group III patients. Continued heavy consumption of phenacetin may lead to increased production of the toxic metabolites that lead to methemoglobin formation.

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