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Methylene blue, when injected intravenously as an antidote, is itself first reduced to leucomethylene blue, which then reduces the heme group from methemoglobin to hemoglobin. Methylene blue can reduce the half life of methemoglobin from hours to minutes. [ 12 ]
Methylene blue is given as a 1% solution (10 mg/ml) 1 to 2 mg/kg administered intravenously slowly over five minutes. Although the response is usually rapid, the dose may be repeated in one hour if the level of methemoglobin is still high one hour after the initial infusion. Methylene blue inhibits monoamine oxidase, and serotonin toxicity can ...
The disorder can cause heart abnormalities and seizures if the amount of methemoglobin in the blood exceeds 20 percent, but at levels between 10 and 20 percent it can cause blue skin without other symptoms. Most of the Fugates lived long and healthy lives. The "bluest" of the blue Fugates, Luna Stacy, had 13 children and lived to age 84. [6]
Minor side effects include green or blue discoloration of urine; however, significant side effects include worsening of the present methemoglobinemia. Because methylene blue is an oxidizing agent itself, when it is not effectively reduced, NADPH will not be properly restored in the cell for electron transfer, resulting in increased levels of ...
Notably, methylene blue is used as the main treatment for methemoglobinemia, however in G6PD individuals, methylene blue may cause further oxidative stress and that may induce or worsen hemolysis in those with methemoglobinemia. [1] Hemolytic anemia may also occur secondarily due to thrombotic microangiopathy after exposure to certain drugs.
The first-line treatment for severe methemoglobinemia is methylene blue, a medication that will reduce methemoglobin in the blood. This is possible because methylene blue oxidizes NADPH , which in turn can convert methemoglobin back to hemoglobin.
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The most widely employed photosensitizer in clinical practice is the phenothiazine derivative, methylene blue, which carries a +1 charge. [27] Methylene blue is also favored due to its long record of safe use in patients, both in surgical staining and the systemic treatment of methemoglobinemia. [28]
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