Efficacy of methylene blue in a murine model of amlodipine overdose

Amlodipine overdoses have significant cardiac toxicity and are difficult to treat. Methylene blue has potential as a treatment for overdoses. A randomized controlled study of methylene blue as a treatment for amlodipine toxicity was conducted in C57Bl/6 mice. A baseline echocardiography was followed...

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Veröffentlicht in:The American journal of emergency medicine 2021-07, Vol.45, p.284-289
Hauptverfasser: de Castro Brás, Lisandra E., Baccanale, Cecile L., Eccleston, Lex, Sloan, Trey, St Antoine, Jason C., Verzwyvelt, Steven Matthew-Lewis, Pittman, Peggy, O'Rourke, Dorcas, Meggs, William J.
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container_title The American journal of emergency medicine
container_volume 45
creator de Castro Brás, Lisandra E.
Baccanale, Cecile L.
Eccleston, Lex
Sloan, Trey
St Antoine, Jason C.
Verzwyvelt, Steven Matthew-Lewis
Pittman, Peggy
O'Rourke, Dorcas
Meggs, William J.
description Amlodipine overdoses have significant cardiac toxicity and are difficult to treat. Methylene blue has potential as a treatment for overdoses. A randomized controlled study of methylene blue as a treatment for amlodipine toxicity was conducted in C57Bl/6 mice. A baseline echocardiography was followed by gavage administration of amlodipine (90 mg/kg). Five minutes after gavage, animals received either vehicle solution (controls) or methylene blue (20 mg/kg) by intra-peritoneal injection. Animals were continuously monitored, and cardiac parameters were acquired every 15 min up to two hours. Only 50% of control animals survived to the two-hour endpoint compared to 83% that received methylene blue. Amlodipine delivery induced significant reduction in left ventricular ejection fraction (EF), fractional shortening (FS), stroke volume (SV), and cardiac output (CO) in the vehicle treated animals relative to animals in the treatment group (p 
doi_str_mv 10.1016/j.ajem.2020.08.077
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Methylene blue has potential as a treatment for overdoses. A randomized controlled study of methylene blue as a treatment for amlodipine toxicity was conducted in C57Bl/6 mice. A baseline echocardiography was followed by gavage administration of amlodipine (90 mg/kg). Five minutes after gavage, animals received either vehicle solution (controls) or methylene blue (20 mg/kg) by intra-peritoneal injection. Animals were continuously monitored, and cardiac parameters were acquired every 15 min up to two hours. Only 50% of control animals survived to the two-hour endpoint compared to 83% that received methylene blue. Amlodipine delivery induced significant reduction in left ventricular ejection fraction (EF), fractional shortening (FS), stroke volume (SV), and cardiac output (CO) in the vehicle treated animals relative to animals in the treatment group (p &lt; 0.05 vehicle versus Methylene blue for EF, FS, SV, CO, and HR). The amlodipine dose induced cardiotoxicity that were effects were more pronounced in the untreated group. 50% vehicle controls quickly progressed into heart failure (within 90 min of exposure) and did not survive the two h observation endpoint. Distinctly, only one animal from the Methylene blue treatment group did not survive (83% survival) the study. Additionally, the surviving animals from the Methylene blue group displayed significantly higher ejection fraction, fractional shortening, stroke volume, and cardiac output compared to vehicle group, indicating that methylene blue preserved cardiac function. 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Methylene blue has potential as a treatment for overdoses. A randomized controlled study of methylene blue as a treatment for amlodipine toxicity was conducted in C57Bl/6 mice. A baseline echocardiography was followed by gavage administration of amlodipine (90 mg/kg). Five minutes after gavage, animals received either vehicle solution (controls) or methylene blue (20 mg/kg) by intra-peritoneal injection. Animals were continuously monitored, and cardiac parameters were acquired every 15 min up to two hours. Only 50% of control animals survived to the two-hour endpoint compared to 83% that received methylene blue. Amlodipine delivery induced significant reduction in left ventricular ejection fraction (EF), fractional shortening (FS), stroke volume (SV), and cardiac output (CO) in the vehicle treated animals relative to animals in the treatment group (p &lt; 0.05 vehicle versus Methylene blue for EF, FS, SV, CO, and HR). The amlodipine dose induced cardiotoxicity that were effects were more pronounced in the untreated group. 50% vehicle controls quickly progressed into heart failure (within 90 min of exposure) and did not survive the two h observation endpoint. Distinctly, only one animal from the Methylene blue treatment group did not survive (83% survival) the study. Additionally, the surviving animals from the Methylene blue group displayed significantly higher ejection fraction, fractional shortening, stroke volume, and cardiac output compared to vehicle group, indicating that methylene blue preserved cardiac function. 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Methylene blue has potential as a treatment for overdoses. A randomized controlled study of methylene blue as a treatment for amlodipine toxicity was conducted in C57Bl/6 mice. A baseline echocardiography was followed by gavage administration of amlodipine (90 mg/kg). Five minutes after gavage, animals received either vehicle solution (controls) or methylene blue (20 mg/kg) by intra-peritoneal injection. Animals were continuously monitored, and cardiac parameters were acquired every 15 min up to two hours. Only 50% of control animals survived to the two-hour endpoint compared to 83% that received methylene blue. Amlodipine delivery induced significant reduction in left ventricular ejection fraction (EF), fractional shortening (FS), stroke volume (SV), and cardiac output (CO) in the vehicle treated animals relative to animals in the treatment group (p &lt; 0.05 vehicle versus Methylene blue for EF, FS, SV, CO, and HR). The amlodipine dose induced cardiotoxicity that were effects were more pronounced in the untreated group. 50% vehicle controls quickly progressed into heart failure (within 90 min of exposure) and did not survive the two h observation endpoint. Distinctly, only one animal from the Methylene blue treatment group did not survive (83% survival) the study. Additionally, the surviving animals from the Methylene blue group displayed significantly higher ejection fraction, fractional shortening, stroke volume, and cardiac output compared to vehicle group, indicating that methylene blue preserved cardiac function. In this mouse model of amlodipine overdose, methylene blue decreased cardiac toxicity.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>33041135</pmid><doi>10.1016/j.ajem.2020.08.077</doi><tpages>6</tpages></addata></record>
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identifier ISSN: 0735-6757
ispartof The American journal of emergency medicine, 2021-07, Vol.45, p.284-289
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subjects Amlodipine
Amlodipine - poisoning
Animal models
Animals
Body temperature
Cardiac function
Cardiotoxicity
Congestive heart failure
Disease Models, Animal
Drug dosages
Drug overdose
Drug Overdose - drug therapy
Dyes
Echocardiography
Ejection fraction
Emergency medical care
Heart failure
Heart rate
Laboratory animals
Methylene blue
Methylene Blue - pharmacology
Mice
Mice, Inbred C57BL
Mouse model
Overdose
Peritoneum
Poisoning
Software
Stroke Volume - drug effects
Toxicity
Ventricle
Ventricular Function, Left - drug effects
title Efficacy of methylene blue in a murine model of amlodipine overdose
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