Drug Interactions between Opticaine and silver nitrate topical

Some of the medication in silver nitrate topical may be absorbed into the bloodstream following local application. When present in sufficient concentrations in the blood, silver nitrate topical may cause methemoglobinemia, a rare condition that can lead to oxygen deprivation in tissues and vital organs due to reduced oxygen-carrying capacity of the blood. Methemoglobinemia is most likely to occur when silver nitrate topical is used in burn patients to prevent infection. The risk is increased when combined with other medications that can also induce methemoglobinemia such as tetracaine ophthalmic. Individuals may be more susceptible to developing methemoglobinemia during treatment with these medications if they are very young (especially neonates and infants) or have anemia, diseases of the heart or lungs, blood circulation disorders, liver cirrhosis, shock, sepsis, and certain genetic predispositions such as NADH cytochrome-b5 reductase deficiency, glucose-6-phosphate dehydrogenase deficiency, and hemoglobin M. In addition, use of silver nitrate topical on inflamed or abraded areas or broken skin, as well as excessive use such as application of large doses or on larger than recommended areas, can increase absorption and result in high blood levels of the medication. Close medical supervision may be necessary when medications that can cause methemoglobinemia are used together. Signs and symptoms of methemoglobinemia may be delayed by several hours after treatment. Patients (or their caregivers) should seek immediate medical attention if they develop a gray discoloration of the skin, mouth, or nail bed; nausea; headache; dizziness; lightheadedness; fatigue; shortness of breath; rapid or shallow breathing; a rapid heartbeat; palpitation; anxiety; or confusion. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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