Methylene Blue, Midodrine, and Pseudoephedrine

A Review of Alternative Agents for Refractory Hypotension in the Intensive Care Unit

Megan A. Van Berkel, Laura A. Fuller, Anne Alexandrov, G. Morgan Jones

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Hypotensive episodes are common among patients in the intensive care unit and can lead to multiorgan failure if uncontrolled. Fluid administration and continuous infusion of vasoactive agents are frequently used for management of hypotension; however, both therapies may be associated with adverse effects including pulmonary edema and tissue necrosis. In addition, availability of these first-line agents has been impacted by the increasing occurrence of drug shortages. Methylene blue, pseudoephedrine, and midodrine have been considered potential alternatives to standard therapy. These agents may not only be used when first-line agents are unavailable due to shortages, but they may also aid in reducing the cumulative dose of other vasoactive agents used. The purpose of this review was to discuss strategies for the safe and effective use of methylene blue, pseudoephedrine, and midodrine for the treatment of hypotension in the critically ill.

Original languageEnglish (US)
Pages (from-to)345-358
Number of pages14
JournalCritical Care Nursing Quarterly
Volume38
Issue number4
DOIs
StatePublished - Sep 7 2015

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Midodrine
Pseudoephedrine
Methylene Blue
Hypotension
Intensive Care Units
Pulmonary Edema
Critical Illness
Necrosis
Therapeutics
Pharmaceutical Preparations

All Science Journal Classification (ASJC) codes

  • Critical Care

Cite this

Methylene Blue, Midodrine, and Pseudoephedrine : A Review of Alternative Agents for Refractory Hypotension in the Intensive Care Unit. / Van Berkel, Megan A.; Fuller, Laura A.; Alexandrov, Anne; Morgan Jones, G.

In: Critical Care Nursing Quarterly, Vol. 38, No. 4, 07.09.2015, p. 345-358.

Research output: Contribution to journalArticle

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