Abstract | INTRODUCTION: CASE REPORT: A 59-year-old woman taking preoperative venlafaxine and trazodone was given a single dose of 2 mg/kg methylene blue (167 mg) during a planned coronary artery bypass and mitral valve repair. Postoperatively, she was febrile to 38.7°C and developed full-body tremors, rhythmic twitching of the perioral muscles, slow conjugate roving eye movements, and spontaneous movements of the upper extremities. Electroencephalography revealed generalized diffuse slowing consistent with toxic encephalopathy, and a computed tomography scan showed no acute process. The patient's symptoms were most consistent with a methylene blue-induced serotonin syndrome. Her motor symptoms resolved within 48 hours and she was eventually discharged home. DISCUSSION:
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Authors | Christina J Smith, Dorothy Wang, Anna Sgambelluri, Robert S Kramer, David J Gagnon |
Journal | Journal of pharmacy practice
(J Pharm Pract)
Vol. 28
Issue 2
Pg. 207-11
(Apr 2015)
ISSN: 1531-1937 [Electronic] United States |
PMID | 25613051
(Publication Type: Case Reports, Journal Article)
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Copyright | © The Author(s) 2015. |
Chemical References |
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Topics |
- Coronary Artery Bypass
- Female
- Humans
- Methylene Blue
(adverse effects)
- Middle Aged
- Mitral Valve
(surgery)
- Serotonin Syndrome
(chemically induced)
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