Methylene Blue (ProvayBlue)

Question 1

Methylene Blue (ProvayBlue) class

Answer 1

Antidote; diagnostic agent

Question 2

Methylene Blue (ProvayBlue) MOA

Answer 2

Reduced to leukomethylene blue which acts as an electron donor & nonenzymatically reduces methemoglobin to hemoglobin

Believed to interfere w/ NO-cGMP pathway inhibiting the vasodilating effect on smooth muscle

Question 3

Methylene Blue (ProvayBlue) dosage

Answer 3

Methemglobinemia: 1-2 mg/kg over 5 min (MAX 7-8mg/kg)

Vasoplegic syndrome: 1-2 mg/kg over 10-20 min for bolus; 0.25mg/kg/hr for 48-72 hrs

Question 4

Methylene Blue (ProvayBlue) characteristics

Answer 4

O: almost immediate

P: 20-60 min

D: several hrs

Question 5

Methylene Blue (ProvayBlue) considerations

Answer 5

May trigger serotonin syndrome in conjunction w/ SRI

Tachycardia, HTN, precocial pain, cyanosis, confusion, headache

May cause artificial reading w/ pulse ox
Inj slowly to prevent a local high concentration form producing additional methemoglobinemia

Monitor I/Os and hgb

Question 6

Methylene Blue (ProvayBlue) E/M

Answer 6

Bile, feces, urine (33% as leukomethylene blue)