Serotonin syndrome Flashcards
1
Q
What is the serotonin syndrome
A
Potentially fatal toxic reaction resulting from increased synaptic serotonin levels in the brain stem and spinal cord.
2
Q
Which drug combinations cause the serotonin syndrome, which is the most common
A
Commonest
SSRI + MAOI
Tricyclic Anti-depressants (TCA)
Pethidine
Tramadol
3
Q
Give examples of SSRI
A
Fluoxetine
Paroxetine
Sertraline
4
Q
What advantages do SSRI’s have over TCA
A
Fewer Side Effects Less sedative Fewer anticholinergic side effects Rarely cause bradycardia Safer in overdose than TCAs
5
Q
What are the side effects of SSRIs
A
GIT: N,V,C,D
CNS: Sleep disturbance, agitation
Sexual dysfunction
High dose
- NSAIDS + SSRI —> reduce pot aggregation
- SIADH
- Inhibit CYP450
6
Q
What are the clinical characteristics of serotonin syndrome
A
Behaviour change
Muscle rigidity/clonus/hyper-reflexia
Autonomic instability
May progress to:
- seizures
- Oculogyric crisis
- DIC
- Rhabdomyolysis
- AKI
- Arryhmia
- Coma
- Death
