Icy Hot Kills Teen

[crank-e]

NEW YORK - A medical examiner blamed a 17-year-old track star's death on the use of too much muscle cream, the kind used to soothe aching legs after exercise.

Arielle Newman, a cross-country runner at Notre Dame Academy on Staten Island, died after her body absorbed high levels of methyl salicylate, an anti-inflammatory found in sports creams such as Bengay and Icy Hot, the New York City medical examiner said Friday.

The medical examiner's spokeswoman, Ellen Borakove, said the teen used "topical medication to excess." She said it was the first time that her office had reported a death from using a sports cream.

Newman, who garnered numerous track awards, died April 13. She had gone to a party the night before, then returned home and spent hours talking with her mother.

Methyl salicylate poisoning is unusual, and deaths from high levels of the chemical are rare.

"Chronic use is more dangerous than one-time use," Edward Arsura, chairman of medicine at Richmond University Medical Center, told the Staten Island Advance on Friday. "Exercise and heat can accentuate absorption."

Dr. Ronald Grelsamer, of Mount Sinai Medical Center, said Newman had a very abnormal amount of methyl salicylate in her body.

"She either lathered herself with it, or used way too much, or she used a normal amount and an abnormal percentage was absorbed into her body," he said.

Her mother, Alice Newman, said she still couldn't believe her daughter's death was caused by a sports cream.

"I am scrupulous about my children's health," she told the Advance. "I did not think an over-the-counter product could be unsafe."

[frizgolf]

"I am scrupulous about my children's health," she told the Advance. "I did not think an over-the-counter product could be unsafe."
Not to be insensitive, but too much of anything, even water, can be unsafe.

[Slar]

Her mother, Alice Newman, said she still couldn't believe her daughter's death was caused by a sports cream.

"I am scrupulous about my children's health," she told the Advance. "I did not think an over-the-counter product could be unsafe."I can't imagine what she is going through and it's a terrible situation, but that quote is just retarded.

[The Sheck]

I don't think it's "retarded," really. It's more of not really thinking about what you're purchasing. How many people really read the warning labels on packaging, too? People just assume something that doesn't require a prescription is automatically "safe" when it's being sold in a store, that's all.

[classicgrrl]

I cannot believe the poor girl was in that much pain that she had to use that much.

Man, she must have SERIOUSLY been hurting. Why didn't her coach notice it?

[SheepNutz]

I smell a lawsuit coming. I have some Icy Hot here at home, and it warns against allergies to salicylate and to keep it away from eyes, mucous membranes, broken, and irritated skin, but nothing about excessive use. The LD50 for methyl salicylate in rats is 887 mg/kg, and the LDLO (lowest published lethal dose) for humans is 101 mg/kg. My tube of Icy Hot is 35.4g (35,400mg or 1.25 oz.), and it's 30% methyl salicylate, so one tube has 10,620mg of methyl salicylate. Let's say she weighed 100lb (45.5kg), if 100% of methyl salicylate in the tube was absorbed (not likely), then she would have absorbed 233 mg/kg. That's a lot of icy hot to put on yourself, but it's definitely something that could happen to people. I bet they'll put more warning on their labels soon. It's interesting too, because methyl salicylate is basically wintergreen oil, so I wonder if anyone has tried to OD on life savers or the like.

[DaHood]

I guess you could say that she was rubbed out.

[skidminix]

I just KNEW these guys were hardcore...

http://www.geocities.com/icyhotstuntazz/ichstun.jpg

[Seattle93]

I just KNEW these guys were hardcore...

http://www.geocities.com/icyhotstuntazz/ichstun.jpg

wrong thread (http://woxy.com/boards/showthread.php?t=37351) ;)

[bjk15]

I smell a lawsuit coming. I have some Icy Hot here at home, and it warns against allergies to salicylate and to keep it away from eyes, mucous membranes, broken, and irritated skin, but nothing about excessive use. The LD50 for methyl salicylate in rats is 887 mg/kg, and the LDLO (lowest published lethal dose) for humans is 101 mg/kg. My tube of Icy Hot is 35.4g (35,400mg or 1.25 oz.), and it's 30% methyl salicylate, so one tube has 10,620mg of methyl salicylate. Let's say she weighed 100lb (45.5kg), if 100% of methyl salicylate in the tube was absorbed (not likely), then she would have absorbed 233 mg/kg. That's a lot of icy hot to put on yourself, but it's definitely something that could happen to people. I bet they'll put more warning on their labels soon. It's interesting too, because methyl salicylate is basically wintergreen oil, so I wonder if anyone has tried to OD on life savers or the like.
nice analysis, sNutz.

and it's been said, a lot of OTC products can be deadly if their precautions aren't followed, not to mention drinking... which is an assumption, but it could definitely be a contributor...

- Consult physician if pain lasts 10 days or more, if redness is present...
- If you have any of the following health problems, consult your doctor or pharmacist before using this product: asthma, injured/irritated skin in the affected area, growths in the nose (nasal polyps).
- Menthol may give rise to hypersensitivity reactions including contact dermatitis (inflammation of the skin).
- Systemic poisoning can occur from its application to large areas of the skin.
- Treatment of acute poisoning may be aimed at preventing absorption, treatment of the fluid and acid base balance and other electrolyte problems, or promoting elimination of the drug.
- Stop using this medication and tell your doctor immediately if any of these unlikely but serious side effects occur: blistering/swelling/severe redness at the application site, nausea/vomiting, ringing in the ears.
- A very serious allergic reaction to this drug is rare. However, seek immediate medical attention if you notice any symptoms of a serious allergic reaction, including: rash, itching, swelling, severe dizziness, trouble breathing.
- This medication may be harmful if swallowed. If swallowing or overdose is suspected...


here is a research article i found:
Serum concentrations of salicylic acid following topically applied salicylate derivatives
P Morra, WR Bartle, SE Walker, SN Lee, SK Bowles, and RA Reeves

The Annals of Pharmacotherapy: Vol. 30, No. 9, pp. 935-940.

OBJECTIVE: To compare the rate and extent of systemic salicylate absorption following single and multiple applications of two topically applied analgesics, one containing methyl salicylate and the other containing trolamine salicylate.

DESIGN: Two-period, two-treatment, randomized, crossover, multiple-dose study in healthy men and women volunteers.

PARTICIPANTS: Six men and six women volunteers, 21-44 years of age.

INTERVENTIONS: Subjects applied 5 g of an ointment containing 12.5% methyl salicylate twice daily for 4 days (8 doses) or a cream containing trolamine 10% twice daily for two doses, to a 10-cm2 area on the thigh. Treatment order and leg (right or left) were assigned randomly. Subjects were crossed over to the alternate treatment on the other leg after a minimum washout period of 7 days.

MAIN OUTCOME MEASURES: The total amount of salicylate recovered in the urine during two dosing intervals (24 hours) on each study day, relative to the applied dose, was used to calculate the bioavailability of each product. Mean standard pharmacokinetic parameters including area under the curve, maximum concentration (Cmax), time to maximum concentration, and minimum concentrations at steady-state were determined from serum concentrations. Serum concentrations were fit to three pharmacokinetic models and the suitability of each model was evaluated. Estimates of absorption rate constant, clearance, volume, and fraction absorbed on day 1 were estimated by using the best-fitting model.

RESULTS: Salicylic acid could not be detected in serum after trolamine application. However, concentrations between 0.31 and 0.91 mg/L were detected within 1 hour of the first application of methyl salicylate and Cmax between 2 and 6 mg/L were observed following the seventh application on day 4. Both the extent and rate of absorption changed after the first 24 hours. The absorption rate constant increased significantly from the first to the seventh dose (first dose absorption rate constant: 0.16 h-1, seventh dose: 0.28 h-1; p < 0.035). Urinary recovery of total salicylate (salicylic acid and principal metabolites of salicylic acid) during the first 24 hours of the methyl salicylate phase averaged 175.2 mg, exceeding the 6.9 mg (p < 0.05) recovered during the trolamine phase. The recovery of salicylate in the urine in the first 24 hours after application of methyl salicylate was significantly greater than the 1.4% recovered after application of trolamine (p < 0.05). Furthermore, the fraction of methyl salicylate recovered in the urine increased significantly from 15.5% on day 1 to approximately 22% on the second, third, and fourth days.

CONCLUSIONS: A considerable amount of salicylic acid may be absorbed through the skin after topical application of methyl salicylate products and this may increase with multiple applications. Caution is warranted in patients for whom systemic salicylate may be hazardous or problematic.
So, it basically says that hey, guess what, the more crap one throws on, then the more crap gets absorbed, but to be quite honest, the individual couldn't have applied enough to absorb a lethal dose that has been studied; which leads one to believe that she had some sort of reactive side effect that can come about from a number of things.

[patio]

I guess you could say that she was rubbed out.

Thats just cold, man...

[patio]

So, it basically says that hey, guess what, the more crap one throws on, then the more crap gets absorbed, but to be quite honest, the individual couldn't have applied enough to absorb a lethal dose that has been studied; which leads one to believe that she had some sort of reactive side effect that can come about from a number of things.

I think it would have been possible. Whether it was from repeated use or polypharmacy coupled with her low body fat it could have caused liver failure resulting in death.

[frizgolf]

Thats just cold, man...
Icy cold. Well, icy hot to be exact.

[DaHood]

She couldn't take the heat...

[patio]

She couldn't take the heat...

why ya gotta rub it in like that???

[frizgolf]

I think this thread has balmed.

[berzerker]

I think this thread has balmed.

It is quite topical...

[silentpaul]

It got creamed.

[Lidja]

When I heard this on the nightly news, the very last "footnote" they mentioned before jumping do the next story was something like, "The teen was also known to be using patches that contain the same chemicals as well. No telling if she was sleeping with the lethal things, too. You can OD on anything these days. Even toothpaste.

[deetums]

This case reminded me of my track/cross country years...
I ran with kids who would rub that shtuff all over themselves whether they were in pain or not. Some people would apply large amounts to their chest because they thought it helped them to breathe (I even witnessed on kid rubbing it under his nose) while others would dose their whole bodies so they could run through the pain of cramps and whatnot.

So the fact that this could be a case of something like that makes it even more tragic... :(

[epeolatry]

When I heard this on the nightly news, the very last "footnote" they mentioned before jumping do the next story was something like, "The teen was also known to be using patches that contain the same chemicals as well. No telling if she was sleeping with the lethal things, too. You can OD on anything these days. Even toothpaste.

icy hot patches??!??! wtf.

[DaHood]

When she hit those icy patches is when she started to slide.

[frizgolf]

When she hit those icy patches is when she started to slide.
That's just cold.

[patio]

icy hot patches??!??! wtf.

http://www.americarx.com/discpic1/732255.gif

[markalot]

They came back? Where did they go? :cool: