Method On the Efficacy and Peacefulness of Nitrites

[rabbitjack]

Did they both take 25g sodium nitrite?

 

[aRose]

Might be random and useless but I was put on Amitriptyline for GI pain. It makes my stomach pain free for about 4 hours. It's also used post-bladder surgery to reduce internal pain. I also discovered if I take it more than 4-7 days in a row I'll be relatively GI pain feee but it kinda "numbs" my bladder also so I can't ever tell when I need to per so I nearly pee my pants if I don't make myself go every few hours to avoid messing myself.

My theory - would a few days of amityrp leading up to SN maybe help with the acidic burning the poison obviously can cause?

 

[volo]

Thanks OP for sharing all of this with us. I can't imagine the level of pain you're going through having gone through the experience you've shared with us. I want to let you know that all of us in this community stand with you and are here for you.

One or two things struck me about what you had written about Shroomia's regime prior to CTB. At one point you said she took a few domperidones just prior to CTB while in Shroomia's goodbye thread I believe you mention a 36 hour regime of domperidone taken every by 8 hours.

I think it's worth noting here that meto is probably the strongest antiemetic for this. Not sure if Shroomia had access to it though or if she chose not to take it. In my research, the stat dose leaves more meto in the system compared to the 48 hour regime. I think this is the best option against vomiting.

It is also not clear if she took any PPIs, H2 blockers or antacids. I think the stomach pain may be the result of the SN reacting with the acid in the stomach. The reaction may look somewhat like this..

NaNO2 + HCl ----> HNO2 +NaCl

HNO2 (nitrous acid) is unstable especially in warm acidic conditions like the stomach and decomposes as follows:-

2 HNO2 ----> NO + NO2 + H2O

NO (nitric oxide) and NO2(nitrogen dioxide) are toxic and irritant gases. NO2 is a corrosive brown gas that can irritate the stomach lining and trigger nausea or vomiting due to local chemical irritation.

HNO2 formation is strongly pH-dependent. If the gastric pH is raised, protonation of NO2- to HNO2 is suppressed, so fewer nitrosating/irritant species are formed.

In other words the solution seems to be to lower stomach acid (raising the pH and making it less acidic) either through PPIs or H2 blockers or antacids or a combination of all of them.

I think the older PPeH versions used to recommend PPIs, H2 blockers, antacids but then the newer versions seem to have dropped them - not sure why. The newer version just says rather cryptically "The benefit in terms of potentiation...cannot be clearly established. This is not longer advised."

But who is talking about the need for potentiation which is the effect of enhancing the efficacy (or potency) of a drug. SN is pretty potent at the recommended dose in and by itself. You don't need anything to "potentiate" or enhance that. The moot question is if it would reduce discomfort or possible pain.

There is no indication that lowering stomach acid would affect nitrite absorption in any significant way. In fact it might lead to enhanced nitrite absorption in the small intestine as lesser nitrite is converted into the gaseous form of NO and NO2.

PPIs seem to be the most efficient way to do this, but need to be taken over at least 4 to 5 days to achieve good enough acid suppression. Just taking a stat dose before CTB might not be of much use in this regard. These need time to have their effect. People with acid reflux issues are usually prescribed a course of 4 to 8 weeks to achieve maximal acid suppression, but as per my research about 4 to 5 days or maybe a week should be sufficient.

A section of the PPeH under the chapter "Supplementary drugs" recommends 40 mg of nexium daily about 30 to 60 mins before breakfast and 800 mg of cimetidine 30 to 60 mins before dinner at night daily. They need to be taken apart as the PPI needs acidic activation, so taking an H2 blocker at the same time or shortly before may blunt the PPIs activation (since there's not enough acid to activate it).

PPIs work over a longer time period but can deliver greater overall acid suppression close to 98% and have a more durable effect (24 to 48 hours). Cimetidine is faster acting but achieves only about 60 to 70% of acid suppression and its effect is less durable than that of PPIs (4 to 8 hours).

Antacids are extremely short term and are used to neutralize the existing stomach acid alone. So it makes sense for them to be taken just about 45 mins prior to CTB. Their effect lasts only about 30 to 60 mins.

Can I pls PM you? I have a further Q about digestive system drugs. TY

I've read some reports here by people who took way less than is recommended in PPEH (just a few grams) and would very likely had died were they not 'rescued'. Interestingly they didn't report any serious adverse effects. In general they were quite positive about the method and said that they would use it again. The only drawback was a longer time to unconsciousness. There is also a report of a nurse who died from as little as 1 gram of SN. Do you think that taking a large amount (20+ grams) would actually cause most of the suffering and pain that some people unfortunately have experienced? To me it seems logical after reading what you said about the chemical reactions taking place in the stomach and how they probably could cause chemical burns in it and pain. Please correct me if I'm wrong.

It's just my opinion, but I think it's very irresponsible of Nitschke to recommend such high doses when a way smaller ones are lethal. Why? Because the more the better? One article I've read stated that for humans a lethal dose is somewhere between 0.7 and 3.6 grams. Other source stated a lethal dose to be 78 mg/kg of body weight. Even so, with my body weight (60 kg.) I'd only need 4.6 gr. And even if I double that it would be 9.2 gr. Why on Earth would I need to take 20 or 25 gr? I want to euthanize myself (euthanasia actually means 'good death') and not to simply execute myself.

Once I read somewhere that if you live by the book you'll die from a mistake in it. For so many people PPEH is like the Bible and they would rather follow it by the letter because it is THE BOOK than do any extra research and learn from as many experiences as they can, and there are plenty of those on this site.

Also, LD50 is not a good reference for humans, as these values are derived from tests on animals, mostly rats and rats are generally known to tolerate way higher doses of poisons than humans.

I'm looking forward to your reply!

Can I pls PM you? I have a further Q about digestive system drugs, and the dose/weight. TY.

 

[Endisclose]

Can I pls PM you? I have a further Q about digestive system drugs. TY

Okay.

 

[Nolongerlive]

Just some thoughts not related to the topic.
The thread title actually reminds me of the research papers been reading in the past.