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Flashcards in The Syndromes Deck (42)
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1
Q

Name the syndromes (4)

A

Serotonin Syndrome
Anticholinergic “toxidrome”
Neuroleptic malignant (NM) syndrome
Malignant hyperthermia

2
Q

Serotonin syndrome - medication history

A

Pro-serotinergic drug

3
Q

Serotonin syndrome - time to develop

A

< 12 hr

4
Q

Serotonin syndrome - vital signs

A

HTN
Tachycardia
Tachypnea
Hyperthermia (>41.1)

5
Q

Serotonin syndrome - Pupils / Mucosa / Skin

A

Mydriasis
Sialorrhea
Diaphoresis

6
Q

Serotonin syndrome - Bowel sounds

A

Hyperactive

7
Q

Serotonin syndrome - Neuro-muscular tone

A

Increasesed (mostly lower limbs)

8
Q

Serotonin syndrome - Neuro-muscular reflexes

A

Hyperreflexia

Clonus

9
Q

Serotonin syndrome - Mental status

A

Agitation

Coma

10
Q

Anticholinergic “toxidrome” - medication history

A

Anti-cholinergic agent

11
Q

Anticholinergic “toxidrome” - time to develop

A

< 12 hr

12
Q

Anticholinergic “toxidrome” - vital signs

A

HTN
Tachycardia
Tachypnea
Hyperthermia (<38.8)

13
Q

Anticholinergic “toxidrome” - Pupils / Mucosa / Skin

A

Mydriasis
Dry Erythema
Hot and dry to touch

14
Q

Anticholinergic “toxidrome” - bowel sounds

A

Decreased / Absent

15
Q

Anticholinergic “toxidrome” - Neuro-muscular tone

A

Normal

16
Q

Anticholinergic “toxidrome” - Neuro-muscular reflexes

A

Normal

17
Q

Anticholinergic “toxidrome” - Mental status

A

Agitated delirium

18
Q

NM syndrome - medication history

A

Dopamine antagonist

19
Q

NM syndrome - time to develop

A

1-3 days

20
Q

NM syndrome - Vital signs

A

HTN
Tachycardia
Tachypnea
Hyperthermia (>41.1)

21
Q

NM syndrome - Pupils / Mucosa / Skin

A

Normal
Sialorrhea
Pallor, diahporesis

22
Q

NM syndrome - Bowel sounds

A

Normal or decreased

23
Q

NM syndrome - neuromuscular tone

A

“Lead pipe” rigidity

24
Q

NM syndrome - neuromuscular reflexes

A

Bradyreflexia

25
Q

NM syndrome - Mental status

A

Stupor, alert mutism, coma

26
Q

Malignant hyperthermia - medication history

A

Inhalational anasthesia

27
Q

Malignant hyperthermia - time to develop

A

30 min - 24 hr

28
Q

Malignant hyperthermia - vital signs

A

HTN
Tachycardia
Tachypnea
Hyperthermia (up to 46)

29
Q

Malignant hyperthermia - Pupils / Mucosa / Skin

A

Normal
Normal
Mottled appearance / diaphoresis

30
Q

Malignant hyperthermia - Bowel sounds

A

Decreased

31
Q

Malignant hyperthermia - Neuromuscular tone

A

Rigor mortis “like” rigidity

32
Q

Malignant hyperthermia - Neuromuscular reflexes

A

Hyporeflexia

33
Q

Malignant hyperthermia - mental status

A

Agitation

34
Q

Serotonin syndrome Tx

A

Discontinue precipitating drugs
Supportive management
Serotonin antagonist - cyproheptadine

35
Q

NM syndrome Tx

A
Discontinue precipitating drugs
Supportive management
Dopamine agonists (Bromocriptine >> Amantadine)
Muscle relaxant (dantrolene)
Lorazepam
36
Q

Malignant Hyperthermia Tx

A
IV Dantrolene
Correct metabolic acidosis
Monitor serum potassium
- insulin / glucose
- calcium chloride or gluconate
- IV lidocaine (arrhythmia)
Cool to < 38
Maintain urinary output
37
Q

Anticholinergic Toxidrome Tx

A

Cooling
Benzos
Physostigmine (CI w/ TCAs bc seizures)
-anti-cholinesterase agent

38
Q

Cyproheptadine indication/MOA

A

Serotonin Syndrome

39
Q

bromocriptine indication/MOA

A

Neuroleptic Malignant Syndrome

40
Q

dantrolene indication/MOA

A

Neuroleptic Malignant Syndrome

41
Q

physostigmine indication/MOA

A

Anti-ACh poisoning / anti-cholinesterase

42
Q

amantadine indication/MOA

A

Parkisonian syndrome / DA releaser & enhancer (NMDA antagonist too)