Seretonin syndrome mx

Question 1

presentation psych

Answer 1

• Agitation
• Confusion
• Hypomania
• Seizures

Question 2

presentation neurological

Answer 2

• Increased muscle tone
• Tremor
• Shaking
• Hyperreflexia
• Clonus
• Hyperreflexia and clonus are particularly important and often specific signs

Question 3

presentation autonomic

Answer 3

• Hypertensionor hypotension
• Tachycardia
• Fever
• Diarrhoea

Question 4

points from hx

Answer 4

• within first coupla months of starting an SSRI
• when there are drug interactions, particularly between tramadolol and sertraline.
• ask about migraines (triptans)

Question 5

ix findings

Answer 5

• Increased WCC
• Increased CK

Question 6

mx

Answer 6

Cease the offending drugs!

mild - self-resolve 72hrs of cessation // hospital admission not required

severe (hyperthermia) - ICU admission. cyproheptadine PO 4-8mg, repeat 2-hourly

Question 7

criteria for severe cases

Answer 7

HYPERTHERMIA - tx aggressively: ice packs, cooling sprays

rhabdo // ARDS // DIC // hypertension // seizures