front 1 What is the clinical trial of SS | back 1 Altered mental status Autonomic hyperactivity Neuromuscular abnormalities |
front 2 What receptors are associated with SS | back 2 5HT1 (activation) and 5HT2 (antagonism ) |
front 3 5 drug classes associated with SS | back 3 SSRIs (fluoxetine) anti-depressants MAOIs (tumeric) Anticonvulsants Analgesics (fentanyl) |
front 4 Presentation of SS | back 4 Hyperreflexia Bruxism (grinding teeth) Sweating Tachycardia Cog wheel rigidity Vomit |
front 5 Diagnosis of SS | back 5 O: Sudden <24 hours V: T>41.1C, tachycardia P: mydriasis O: NM hyperactivity, diaphoresis, hyperactive bowel sounds |
front 6 Supportive treatment of SS | back 6 Stop offending agent IV fluids Temp control Hemodynamic stability ECG monitoring |
front 7 What class of agents may be used for sedation in SS | back 7 BZDs |
front 8 What agents may be used for hypertension in SS | back 8 esmolol or nitroprusside |
front 9 What agents may be used for hypotension in SS | back 9 NE, epinephrine, phenylephrine |
front 10 What agents may be used for paralysis in SS | back 10 Rocuronium or vecuronium |
front 11 What agent is used for agitation despite discontinuation of serotonergic agents, adequate sedation, and supportive care | back 11 Cyproheptadine |
front 12 What three agents should be avoided in SS | back 12 Propanolol Bromocriptine Dantrolene |
front 13 What syndrome is caused by an adverse drug reaction to medications with dopamine receptor antagonist or by rapid withdrawal from a dopaminergic medication | back 13 Neuroleptic malignant syndrome |
front 14 Presentation of Neuroleptic malignant syndrome | back 14 F.A.R.M Fever Autonomic dysfunction Rigidity Mental status changes |
front 15 Lead pipe muscle rigidity is associated with what disorder? | back 15 Neuroleptic malignant syndrome |
front 16 What is the hallmark symptom of Neuroleptic malignant syndrome | back 16 Delirium |
front 17 Neuroleptic malignant syndrome: | back 17 O: Slow, days to weeks V: T>41.1C, tachycardia P: Mydriasis or normal |
front 18 Abnormal labs associated with Neuroleptic malignant syndrome | back 18 CK <600 UI/L Possibly high SCr and BUN WBC >10 Increased CRP, fibrinogen, ESR |
front 19 What are the three major criteria of the Levenson criteria for Neuroleptic malignant syndrome | back 19 HRE 1. Hyperthermia 2. Rigidity 3. Elevated CPK >1000 UI/L |
front 20 Three causative agents for Neuroleptic malignant syndrome | back 20 Haloperidol Risperidone Levodopa |
front 21 What agent is a D2 receptor agonist and may be used in combination with supportive care, BZDs +/- dantrolene in patients with moderate to severe symptoms | back 21 Bromocriptine |
front 22 What agent is a direct-acting skeleton muscle relaxant that interferes with release of Ca2+ from sarcoplasmic reticulum | back 22 Dantrolene |
front 23 What is the BBW of Dantrolene | back 23 Hepatotoxicity |
front 24 BBW of amantadine | back 24 ACUTE AND POTENTIALLY FATAL WITHDRAWAL SYNDROME!! |
front 25 Which disorder is associated with general anesthesia | back 25 Malignant hyperthermia due to the acceleration of metabolism in skeletal muscles |
front 26 What gene is associated with Malignant hyperthermia | back 26 RyR1 |
front 27 Malignant hyperthermia is inherited as a dominant trait? | back 27 True (CHCT diagnostic test) |
front 28 Unique signs of malignant hyperthermia | back 28 Hypermetabolic crisis Metabolic and respiratory acidosis Rhabdo |
front 29 CK >10,000 is associated with what disorder | back 29 Malignant hyperthermia |
front 30 Malignant hyperthermia | back 30 O: VERY SUDDEN, MINUTES TO HOURS V: Temp as high as 46C P: Normal O: Hypoactive bowel sounds |
front 31 Rising end-tidal CO2 is associated with what disorder | back 31 Malignant hyperthermia |
front 32 Treatment of Malignant hyperthermia | back 32 Dantrolene |
front 33 Other therapies that should be present in a malignant hyperthermia kit | back 33 Sodium bicarb Dextrose Insulin R Calcium chloride Lidocaine for injection Refrigerated cold saline solution |