The "Syndromes" Flashcards
Your pt is experiencing Serotonin syndrome. What is your course of action?
STOP precipitating drugs immediately.
START serotonin antagonist- cyproheptadine
Control hyperthermia
How can lithium lead to SS?
Incr. serotonin metabolites in CSF. May interact pharmacodynamically w/ SSRIs (prob, incr. serum concentration)
How do the various presentations of the neuroleptic malignant syndrome come about?
Talk about effects on certain parts of the brain…
Blockade of D2 receptors in brain:
:: hypothalamus –> hyperthermia
:: SNS–> autonomic dysfxn
:: nigrostriatal–> ^ muscle rigidity/tremor via extrapyramidal pathways
Talk about pharm management of NMS.
Dantrolene for hyperthermia
Bromocriptine»_space;amantadine for DA agonism
Lorazepam to reduce psychosis, agitation, anxiety
NMS is most commonly seen in the high potency antipsychs such as:
Chlorpromazine (this is low potency) and haloperidol
What is the drug of choice for restoring intracellular Ca2+ levels?
Dantrolene
What are the signs of anticholinergic poisoning?
Diminished parasympathetic activity—> sympathetic overdrive
Pupils dilated
Heart rate elevated
Hyperthermia
How do you treat anticholinergic poisoning?
Physostigmine + cooling methods
DON’T GIVE PHYSOSTIGMINE IN TCA OVERDOSE
ADEs of physostigmine?
Seizures, bradyasystole
What drugs cause NMS?
Dopamine antagonists
What drugs cause serotonin syndrome?
Pro-serotonergic drugs: SSRIs, TCAs, MAOIs, Lithium
What drugs cause malignant hyperthermia?
Succinylcholine
Timeline for Serotonin syndrome, anticholinergic poisoning, NMS, and malignant hypethermia post drug admin:
SS:
Which syndrome is associated w hyperactive bowel sounds?
Serotonin syndrome
Which syndrome(s) are associated with muscle rigidity?
NMS and MH
SS increased muscle rigidity in lower extremities
