Serotonin syndrome

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Flashcards

Serotonin syndrome

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Preguntas

Preguntas del estilo USMLE Step 1

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A 55-year-old woman comes to the emergency department (ED) for evaluation of recurrent left flank pain and vomiting. She has a history of recurrent nephrolithiasis and recently noticed gross blood in her urine. Medical history is notable for obesity, hypertension, hyperlipidemia, depression, and type II diabetes mellitus. The patient has been taking ondansetron at home for nausea as well as losartan, metformin, rosuvastatin, and sertraline for her other medical conditions. On physical exam, the patient has left costovertebral angle tenderness. Blood is detected on urinalysis. The patient's symptoms are well controlled during the ED visit, and she is subsequently discharged with prescription analgesia, additional antiemetics, and urology follow-up. Three days later, the patient is brought back to the ED altered, diaphoretic, and agitated. Temperature is 39.4°C (103°F), pulse is 122/min, respirations are 20/min, and blood pressure is 184/95 mmHg. She has bilateral mydriasis and myoclonus. Which of the following medications was the most likely precipitant of this patient's clinical presentation?

External References

First Aid

2024

2023

2022

2021

Autonomic nervous system

in serotonin syndrome p. 586

Serotonin syndrome p. 407, 562, 568, 587

dextromethorphan p. 705

MAO inhibitors p. 593

MDMA p. 589

oxazolidinones p. 190

Enlaces externos

Resumen

Serotonin syndrome is a potentially life-threatening condition that occurs when there is an excess of serotonin, a neurotransmitter in the brain, leading to a dangerous increase in nerve cell activity. Serotonin syndrome can occur as a result of taking certain medications, including selective serotonin reuptake inhibitors (SSRIs), monoamine oxidase inhibitors (MAOIs), and serotonin-norepinephrine reuptake inhibitors (SNRIs) or taking a combination of medications that increase serotonin levels. Symptoms include agitation, confusion, muscle rigidity and hyperreflexia, hypertension, dysrhythmias, diaphoresis, and tachypnea. Treatment may include discontinuing the culprit drug, supportive management, and providing cyproheptadine.

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