Methylene Blue in Management of Vasoplegic Shock Secondary to Primidone Overdose

Vasoplegic shock refractory to vasopressors is associated with significant morbidity and mortality. Catecholamine driven therapies are first-line in the management of vasoplegic shock. Research regarding use non-catecholamine agents setting lacking. Methylene blue has multiple off-labelled indications for use, but recently been suggested have a role treating mediated by dysregulation nitric oxide, which generated via oxide synthase. inhibits endothelial synthase restores vascular tone through upregulation.