{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,9,16]],"date-time":"2024-09-16T16:46:06Z","timestamp":1726505166914},"reference-count":14,"publisher":"California Digital Library (CDL)","issue":"2","license":[{"start":{"date-parts":[[2022,3,7]],"date-time":"2022-03-07T00:00:00Z","timestamp":1646611200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>ntroduction: As ketamine gains traction as an alternative to opiates in the treatment of chronic pain, ketamine-induced ulcerative cystitis is now being recognized as a complication of its use. The first-line treatment is phenazopyridine, an over-the-counter medication for dysuria that historically has been known to cause methemoglobinemia. This report details the case of a patient presenting to the emergency department (ED) with methemoglobinemia.\nCase Report: A 66-year-old woman with a complicated medical history presented to the ED with anemia and hypoxia after extended use of phenazopyridine for treatment of ketamine-induced ulcerative cystitis. She was found to have methemoglobinemia secondary to phenazopyridine used to treat her ketamine-induced ulcerative cystitis, a previously undocumented sequelae of chronic ketamine use. She was admitted to the hospital for three days and made a full recovery. \nConclusion: This case highlights the need to suspect ketamine-induced ulcerative cystitis in patients who use ketamine chronically and be judicious in the use of phenazopyridine for symptom management to prevent life-threatening complications.<\/jats:p>","DOI":"10.5811\/cpcem.2022.1.55277","type":"journal-article","created":{"date-parts":[[2022,6,2]],"date-time":"2022-06-02T01:08:03Z","timestamp":1654132083000},"page":"137-140","source":"Crossref","is-referenced-by-count":2,"title":["Acquired Methemoglobinemia in a Ketamine-induced Ulcerative Cystitis Patient: A Case Report"],"prefix":"10.5811","volume":"6","author":[{"given":"Spencer","family":"Kozik","sequence":"first","affiliation":[{"name":"University of California \u2013 Irvine, School of Medicine, Irvine, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cali","family":"Kirkham","sequence":"additional","affiliation":[{"name":"University of California \u2013 Irvine Medical Center, Department of Emergency Medicine, Orange, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabriel","family":"Sudario","sequence":"additional","affiliation":[{"name":"University of California \u2013 Irvine Medical Center, Department of Emergency Medicine, Orange, California"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"29705","published-online":{"date-parts":[[2022,3,7]]},"reference":[{"key":"ref0","doi-asserted-by":"publisher","unstructured":"Motov S, Rockoff B, Cohen V, et al. Intravenous subdissociative-dose ketamine versus morphine for analgesia in the emergency department: a randomized controlled trial. Ann Emerg Med. 2015;66(3):222-9.e1.","DOI":"10.1016\/j.annemergmed.2015.03.004"},{"key":"ref1","doi-asserted-by":"publisher","unstructured":"Niesters M, Martini C, Dahan A. Ketamine for chronic pain: risks and benefits. Br J Clin Pharmacol. 2014;77(2):357-67.","DOI":"10.1111\/bcp.12094"},{"key":"ref2","doi-asserted-by":"publisher","unstructured":"Shahani R, Streutker C, Dickson B, et al. Ketamine-associated ulcerative cystitis: a new clinical entity. Urology. 2007;69(5):810-2.","DOI":"10.1016\/j.urology.2007.01.038"},{"key":"ref3","doi-asserted-by":"publisher","unstructured":"Gray T and Dass M. Ketamine cystitis: an emerging diagnostic and therapeutic challenge. Br J Hosp Med (Lond). 2012;73(10):576-9.","DOI":"10.12968\/hmed.2012.73.10.576"},{"key":"ref4","doi-asserted-by":"publisher","unstructured":"Gummin DD, Mowry JB, Spyker DA, et al. 2018 Annual Report of the American Association of Poison Control Centers\u2019 National Poison Data System (NPDS): 36th Annual Report. Clin Toxicol (Phila). 2019;57(12):1220-413.","DOI":"10.1080\/15563650.2019.1677022"},{"key":"ref5","doi-asserted-by":"publisher","unstructured":"Kalsi SS, Wood DM, Dargan PI. The epidemiology and patterns of acute and chronic toxicity associated with recreational ketamine use. Emerg Health Threats J. 2011;4:7107.","DOI":"10.3402\/ehtj.v4i0.7107"},{"key":"ref6","doi-asserted-by":"publisher","unstructured":"Ng SH, Tse ML, Ng HW, et al. Emergency department presentation of ketamine abusers in Hong Kong: a review of 233 cases. Hong Kong Med J. 2010;16(1):6-11.","DOI":"10.1177\/102490791101800404"},{"key":"ref7","doi-asserted-by":"publisher","unstructured":"Noppers IM, Niesters M, Aarts LPHJ, et al. Drug-induced liver injury following a repeated course of ketamine treatment for chronic pain in CRPS type 1 patients: a report of 3 cases. Pain. 2011;152(9):2173-8.","DOI":"10.1016\/j.pain.2011.11.017"},{"key":"ref8","doi-asserted-by":"publisher","unstructured":"Institute of Medicine (US) Committee on Advancing Pain Research, Care, and Education. Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research. 2011. Available at https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK91497. Accessed August 20, 2021.","DOI":"10.17226\/13172"},{"key":"ref9","doi-asserted-by":"publisher","unstructured":"Cohen SP, Bhatia A, Buvanendran A, et al. Consensus guidelines on the use of intravenous ketamine infusions for chronic pain from the American Society of Regional Anesthesia and Pain Medicine, the American Academy of Pain Medicine, and the American Society of Anesthesiologists. Reg Anesth Pain Med. 2018;43(5):521-46.","DOI":"10.1097\/aap.0000000000000808"},{"key":"ref10","doi-asserted-by":"publisher","unstructured":"Huang LK, Wang JH, Shen SH, et al. Evaluation of the extent of ketamine-induced uropathy: the role of CT urography. Postgrad Med J. 2014;90(1062):185-90.","DOI":"10.1136\/postgradmedj-2013-131776"},{"key":"ref11","doi-asserted-by":"crossref","unstructured":"Tsai TH, Cha TL, Lin CM, et al. Ketamine-associated bladder dysfunction. Int J Urol. 2009;16(10):826-9.","DOI":"10.1111\/j.1442-2042.2009.02361.x"},{"key":"ref12","doi-asserted-by":"publisher","unstructured":"Tintinalli JE and Stapczynski JS. (2011). Tintinalli\u2019s Emergency Medicine: A Comprehensive Study Guide. 7th Ed. New York: McGraw-Hill.","DOI":"10.1197\/j.aem.2005.03.024"},{"key":"ref13","unstructured":"Price DP. (2015). Methemoglobin inducers. In: Hoffman RS, Howland M, Lewin NA, Nelson LS, Goldfrank LR, editors. Goldfrank\u2019s Toxicologic Emergencies. 10th Ed. New York: McGraw-Hill."}],"container-title":["Clinical Practice and Cases in Emergency Medicine"],"original-title":[],"deposited":{"date-parts":[[2022,6,2]],"date-time":"2022-06-02T01:08:10Z","timestamp":1654132090000},"score":1,"resource":{"primary":{"URL":"https:\/\/escholarship.org\/uc\/item\/2813d3b5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3,7]]},"references-count":14,"issue-title":["Clinical Practice and Cases in Emergency Medicine"],"journal-issue":{"issue":"2","published-online":{"date-parts":[[2022,5,19]]}},"URL":"https:\/\/doi.org\/10.5811\/cpcem.2022.1.55277","relation":{},"ISSN":["2474-252X","2474-252X"],"issn-type":[{"type":"electronic","value":"2474-252X"},{"type":"print","value":"2474-252X"}],"subject":[],"published":{"date-parts":[[2022,3,7]]}}}