@article{ref1,
title="Benzocaine-adultered street cocaine in association with methemoglobinemia",
journal="Clinical chemistry",
year="1992",
author="McKinney, C. D. and Postiglione, K. F. and Herold, D. A.",
volume="38",
number="4",
pages="596-597",
abstract="A 27-year-old man with a history of cocaine abuse ingested a large quantity of street cocaine in an apparent suicide attempt. Shortly thereafter, he developed tonic-clonic seizures and became cyanotic. An arterial blood gas sample, collected in the emergency department, appeared chocolate-brown and showed pO2 279 mmHg, pCO2 53 mmHg, and pH 7.15. Hemoglobin spectral analysis revealed significant methemoglobinemia (37%). Subsequent gas-chromatographic and mass-spectral analysis of urine confirmed the presence of cocaine (106 mg/L), benzoylecgonine (94 mg/L), and other metabolites. Further testing revealed the presence of benzocaine, a compound known to produce methemoglobinemia. A powder submitted as the &quot;cutting&quot; substance was shown to be benzocaine. When confronted with a possible cocaine overdose (particularly by ingestion), the physician should consider the possible clinical effects of adulterants, especially local anesthetics such as benzocaine.<p /><p>Language: en</p>",
language="en",
issn="0009-9147",
doi="",
url="http://dx.doi.org/"
}