Vasoplegic Shock Treated with Methylene Blue Complicated by Severe Serotonin Syndrome

Journal of Medical Toxicology

Volumn 14, Issue 1, 2018, Pages 100-103

  Chan, Betty S ^a   Becker, Therese ^a   Chiew, Angela L ^a   Abdalla, Ahmed M ^b   Robertson, Tom A ^b   Liu, Xin ^c   Roberts, Michael S ^b,c   Buckley, Nicholas A ^d  

^a PRINCE OF WALES HOSPITAL   (Australia)

^b UNIVERSITY OF SOUTH AUSTRALIA   (Australia)

^c UNIVERSITY OF QUEENSLAND   (Australia)

^d UNIVERSITY OF SYDNEY   (Australia)

Author keywords

Methylene blue; Overdose; Serotonin syndrome; Vasoplegic shock

Indexed keywords

AMLODIPINE; CREATININE; DESVENLAFAXINE; FLUOXETINE; GLUCONATE CALCIUM; LEVETIRACETAM; LITHIUM; METARAMINOL; METHYLENE BLUE; NORADRENALIN; PROMETHAZINE; QUETIAPINE; RAMIPRIL; ROCURONIUM; VASOPRESSIN; VENLAFAXINE; ANTIDOTE;

ADOLESCENT; ARTICLE; CASE REPORT; CLINICAL ARTICLE; DRUG HALF LIFE; ELECTROENCEPHALOGRAPHY; HEART RATE; HEMODYNAMIC PARAMETERS; HUMAN; HYPERTHERMIA; HYPOTENSION; INDUCED HYPOTHERMIA; LIQUID CHROMATOGRAPHY-MASS SPECTROMETRY; MALE; MEAN ARTERIAL PRESSURE; OLIGURIA; PARALYSIS; SEIZURE; SEROTONIN SYNDROME; TRANSTHORACIC ECHOCARDIOGRAPHY; VASOPLEGIA; VENTILATOR ASSOCIATED PNEUMONIA; COMPLICATION; DRUG INTERACTION; DRUG OVERDOSE; GLASGOW COMA SCALE; MAJOR DEPRESSION; SUICIDE ATTEMPT;

ADOLESCENT; ANTIDOTES; DEPRESSIVE DISORDER, MAJOR; DRUG INTERACTIONS; DRUG OVERDOSE; GLASGOW COMA SCALE; HUMANS; MALE; METHYLENE BLUE; SEROTONIN SYNDROME; SUICIDE, ATTEMPTED; VASOPLEGIA;

EID: 85033600670     PISSN: 15569039     EISSN: 19376995     Source Type: Journal    
DOI: 10.1007/s13181-017-0637-1     Document Type: Article

References (19)

1. Lo JC, Darracq MA, Clark RFA. Review of methylene blue treatment for cardiovascular collapse. J Emerg Med. 2014;46:670–9.
2. Isbister GK, Buckley NA, Whyte IM. Serotonin toxicity: a practical approach to diagnosis and treatment. Med J Aust. 2007;187:361–5.
3. Walter-Sack I, Rengelshausen J, Oberwittler H, et al. High absolute bioavailability of methylene blue given as an aqueous oral formulation. Eur J Clin Pharmacol. 2009;65:179–89.
4. Plumb JO, Stewart C, Eddleston M, de Beer T. Prolonged refractory hypotension following combined amlodipine and losartan ingestion responsive to metaraminol. Case Rep Med. 2011;2011:283672.
5. Zhang X, Hintze TH. Amlodipine releases nitric oxide from canine coronary microvessels: an unexpected mechanism of action of a calcium channel-blocking agent. Circulation. 1998;97:576–80.
6. Xu B, Xiao-hong L, Lin G, et al. Amlodipine, but not verapamil or nifedipine, dilates rabbit femoral artery largely through a nitric oxide- and kinin-dependent mechanism. Br J Pharmacol. 2002;136:375–82.
7. Eyer F, Pfab R, Felgenhauer N, et al. Clinical and analytical features of severe suicidal quetiapine overdoses—a retrospective cohort study. Clin Toxicol (Phila). 2011;49:846–53.
8. Pasin L, Umbrello M, Greco T, et al. Methylene blue as a vasopressor: a meta-analysis of randomised trials. Crit Care Resusc. 2013;15:42–8.
9. Fisher J, Taori G, Braitberg G, Graudins A. Methylene blue used in the treatment of refractory shock resulting from drug poisoning. Clin Toxicol (Phila). 2014;52:63–5.
10. Jang DH, Nelson LS, Hoffman RS. Methylene blue in the treatment of refractory shock from an amlodipine overdose. Ann Emerg Med. 2011;58:565–7.
11. Warrick BJ, Tataru AP, Smolinske SA. Systematic analysis of methylene blue for drug-induced shock. Clin Toxicol (Phila). 2016;54:547–55.
12. Oruch R, Pryme IF, Engelsen BA, Lund A. Neuroleptic malignant syndrome: an easily overlooked neurologic emergency. Neuropsychiatr Dis Treat. 2017;13:161–75.
13. Schattner A, Kitroser E, Cohen JD. Fatal neuroleptic malignant syndrome associated with quetiapine. Am J Ther. 2016;23:e1209–10.
14. Top WM, Gillman PK, de Langen CJ, Kooy A. Fatal methylene blue associated serotonin toxicity. Neth J Med. 2014;72:179–81.
15. Smith CJ, Wang D, Sgambelluri A, et al. Serotonin syndrome following methylene blue administration during cardiothoracic surgery. J Pharm Pract. 2015;28:207–11.
16. Petzer A, Harvey BH, Wegener G, Petzer JP, Azure B. A metabolite of methylene blue, is a high-potency, reversible inhibitor of monoamine oxidase. Toxicol Appl Pharmacol. 2012;258:403–9.
17. Ramsay RR, Dunford C, Gillman PK. Methylene blue and serotonin toxicity: inhibition of monoamine oxidase A (MAO A) confirms a theoretical prediction. Br J Pharmacol. 2007;152:946–51.
18. Gillman PK. CNS toxicity involving methylene blue: the exemplar for understanding and predicting drug interactions that precipitate serotonin toxicity. J Psychopharmacol. 2011;25:429–36.
19. Bosse GM, Matyunas NJ. Delayed toxidromes. J Emerg Med. 1999;17:679–90.