Abstract
Methylene blue is used primarily in the treatment of patients with methemoglobinemia. Most recently, methylene blue has been used as a treatment for refractory distributive shock from a variety of causes such as sepsis and anaphylaxis. Many studies suggest that the nitric oxide-cyclic guanosine monophosphate (NO-cGMP) pathway plays a significant role in the pathophysiology of distributive shock. There are some experimental and clinical experiences with the use of methylene blue as a selective inhibitor of the NO-cGMP pathway. Methylene blue may play a role in the treatment of distributive shock when standard treatment fails.
Publication types
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Research Support, N.I.H., Extramural
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Review
MeSH terms
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Anaphylaxis / physiopathology
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Animals
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Antidotes / adverse effects
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Antidotes / pharmacology
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Antidotes / therapeutic use*
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Cyclic GMP / antagonists & inhibitors
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Cyclic GMP / metabolism
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Drug Resistance
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Endothelium, Vascular / drug effects*
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Endothelium, Vascular / enzymology
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Endothelium, Vascular / metabolism
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Enzyme Inhibitors / adverse effects
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Enzyme Inhibitors / pharmacology
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Enzyme Inhibitors / therapeutic use*
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Humans
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Isoenzymes / antagonists & inhibitors
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Isoenzymes / chemistry
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Isoenzymes / metabolism
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Methylene Blue / adverse effects
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Methylene Blue / pharmacology
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Methylene Blue / therapeutic use*
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Models, Biological*
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Muscle, Smooth, Vascular / drug effects
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Muscle, Smooth, Vascular / enzymology
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Muscle, Smooth, Vascular / metabolism
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Nitric Oxide / antagonists & inhibitors
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Nitric Oxide / metabolism
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Nitric Oxide Synthase / antagonists & inhibitors
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Nitric Oxide Synthase / chemistry
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Nitric Oxide Synthase / metabolism
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Second Messenger Systems / drug effects*
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Sepsis / physiopathology
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Shock / drug therapy*
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Shock / etiology
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Shock / metabolism
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Shock, Cardiogenic / drug therapy
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Shock, Cardiogenic / etiology
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Shock, Cardiogenic / metabolism
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Vascular Resistance / drug effects
Substances
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Antidotes
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Enzyme Inhibitors
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Isoenzymes
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Nitric Oxide
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Nitric Oxide Synthase
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Cyclic GMP
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Methylene Blue