Sodium nitrite 300mg/10ml solution for injection ampoules

Abstract Sodium nitrite (NaNO 2 ) is an odorless inorganic compound appearing as a yellowish to white powder, primarily used as a food additive. An alarming increasing trend in suicides involving NaNO 2 ingestion has been recently observed. The aim of this study is to present a systematic review of intentional NaNO 2 poisonings, focusing on the epidemiological characteristics of the victims, their psychiatric history, the setting and circumstances of death, as well as autopsy, histological and toxicological results. A total of 24 papers satisfied the inclusion criteria reporting 94 suicides by NaNO 2 ingestion. Most victims were male (62.8%), belonging to the 13-40-year-old age group. Psychiatric history was available in 43 cases, with depression being the most reported disorder (19 cases). Autopsy and/or external examination were performed in 63 cases, mostly showing unspecific signs of asphyxia and dark discoloration of the hypostasis and blood. Methemoglobin (Met-Hb) levels in blood were available in 49 suicides, ranging from 6 to 92%. In 35 cases levels exceeded 30%, with 19 victims showing concentrations above 50%. Nitrites (NO 2 ) and nitrates (NO 3 ) were analyzed from different biological samples including blood, urine, gastric content, and other tissues. NO 2 were detected in 44 cases, while NO 3 in 30 victims. Blood was the most analyzed matrix with NO 2 and NO 3 concentrations ranging from 0.03 µg/mL to 372.65 µg/mL and from 0.899 µg/mL to 1,597.9 µg/mL, respectively. In addition, a case of fatal self-poisoning by oral ingestion of NaNO 2 , which came to the author’s attention, is presented.

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Antiseptic mouthwash use is widespread due to its oral health benefits. However, its impact on systemic physiological processes, particularly nitric oxide (NO) bioavailability and muscle contractility, is not fully understood. We sought to determine the effects of cetylpyridinium (antibacterial) versus sodium chloride (control) mouthwashes on salivary and breath NO markers and muscle contractile function in healthy young adults. Thirty participants (n = 15/group) completed a randomized, parallel-arm, blinded trial, comparing the two mouthwashes before and after 7 d of treatment. NO bioavailability was inferred via measurement of salivary nitrate (NO3-), nitrite (NO2-), and cyclic guanyl monophosphate (cGMP) concentrations and breath NO level. Contractile function of the knee extensor muscles was determined via isokinetic dynamometry. No changes in salivary NO3-, NO2-, or cGMP or in breath NO were observed in response to either treatment. However, cetylpyridinium mouthwash reduced the percentage of NO2- in saliva (17 ± 10% vs. 25 ± 13%; p = 0.0036). Peak torque at velocities of 0-6.28 rad/s was unaffected by mouthwash use. Calculated maximal knee extensor velocity (Vmax) and power (Pmax) were therefore also unchanged. Cetylpyridinium mouthwash reduces the relative abundance of NO2- in the oral cavity but does not significantly diminish overall NO bioavailability or impair muscle contractile function in healthy young adults.

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BACKGROUND: Over the years, forensic pathology has registered the spread of new methods of suicide, such as the ingestion of sodium nitrite. Sodium nitrite causes increased methemoglobin, resulting in systemic hypoxia, metabolic acidosis, and cyanosis. Since sodium nitrite is a preservative, the ingestion of foods containing an excessive amount of this substance can also cause acute intoxication up to death. The present review is aimed at guiding health professionals in the identification and management of sodium-nitrite-related intoxications and deaths. METHODS: A systematic literature search was carried out on PubMed by following the PRISMA statement's criteria. A total of 35 studies with 132 cases were enrolled, and the data were cataloged in Microsoft Excel. To establish the causal correlation between sodium nitrite ingestion and death, the Naranjo Adverse Drug Reaction Probability Scale was used. RESULTS: In addition to the small number of cases that have currently been published, the study demonstrated that there was a general methodological discrepancy in the diagnostic process. However, some interesting results have emerged, especially in post-mortem diagnostics. CONCLUSION: Sodium-nitrite-related deaths represent a challenge for forensic pathologists; therefore, it is important to promptly recognize the essential features and perform the necessary and unrepeatable examinations for the correct diagnosis of the cause of death.

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The effect of Juniperus communis L. essential oil (JEO) addition at concentrations of 0.01, 0.05 and 0.10 µL/g on pH, instrumental parameters of color, lipid oxidation (2-Thiobarbituric acid reactive substances (TBARS)), microbial growth, texture and sensory attributes of dry fermented sausages produced with different levels of fat (15 and 25%) and sodium nitrite (0, 75 and 150 mg/kg) was assessed. Reduced level of sodium nitrite (75 mg/kg) in combination with all three concentrations of JEO (0.01–0.10 µL/g) resulted in satisfying physico-chemical (color and texture) properties and improved oxidative stability (TBARS < 0.3 mg MDA/kg) of dry fermented sausages produced with 25% of fat. However, sausages produced with 0.10 µL/g of JEO had untypical flavor. No foodborne pathogens (Escherichia coli, Listeria monocytogenes, Salmonella spp. and sulfite-reducing clostridia) were detected in any sample throughout the storage period (225 days). The results of this study revealed significant antioxidative activity of JEO and consequently its high potential as effective partial replacement for sodium nitrite in dry fermented sausages.

Abstract licence: CC BY