Which of the following adverse effects can occur with the use of prilocaine?
a. arrhythmias
b. methemoglobinemia
c. angina
d. diabetes
Prilocaine may cause methemaglobinemia. Normally, hemoglobin transports oxygen when the iron is in the ferrous form. When hemoglobin becomes oxidized, it is converted into methemoglobin, which does not bind to and transport oxygen. Normally, red blood cells are exposed to various oxidant stresses so that blood normally contains about 1% methemoglobin. Excessive methemoglobin levels (methemaglobinemia) reduce the amount of hemoglobin that is available for oxygen transport to the tissues.
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What will be an ideal response?