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Serotonin syndrome
- AMS, autonomic instability (fever, tachy, HTN), neuromuscular (tremor, ↑DTR, clonus)
- Common drugs (many more!): SSRIs, MAOIs, tramadol, ondansetron/Zofran, linezolid, meth
- Complications: seizures, coma, DIC, hypotension, VT, met. acidosis
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- Withdraw causative meds
- Supportive care (O2, IVF)
- Manage HR/BP with short-acting meds like esmolol/nitroprusside)
- Benzos for agitation, BP, HR
- Control hyperthermia (↓ muscle activity) - benzos, cooling blankets
- T > 41: sedation, ETT, paralysis
- Cyproheptadine (blocks serotonin production)
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