血清素综合征
Serotonin syndrome.
作者信息
Volpi-Abadie Jacqueline, Kaye Adam M, Kaye Alan David
机构信息
Department of Anesthesiology, Ochsner Clinic Foundation, New Orleans, LA.
Departments of Anesthesiology and Pharmacology, Louisiana State University School of Medicine, New Orleans, LA.
出版信息
Ochsner J. 2013 Winter;13(4):533-40.
BACKGROUND
Serotonin syndrome is a potentially life-threatening syndrome that is precipitated by the use of serotonergic drugs and overactivation of both the peripheral and central postsynaptic 5HT-1A and, most notably, 5HT-2A receptors. This syndrome consists of a combination of mental status changes, neuromuscular hyperactivity, and autonomic hyperactivity. Serotonin syndrome can occur via the therapeutic use of serotonergic drugs alone, an intentional overdose of serotonergic drugs, or classically, as a result of a complex drug interaction between two serotonergic drugs that work by different mechanisms. A multitude of drug combinations can result in serotonin syndrome.
METHODS
This review describes the presentation and management of serotonin syndrome and discusses the drugs and interactions that can precipitate this syndrome with the goal of making physicians more alert and aware of this potentially fatal yet preventable syndrome.
CONCLUSION
Many commonly used medications have proven to be the culprits of serotonin syndrome. Proper education and awareness about serotonin syndrome will improve the accuracy of diagnosis and promote the institution of the appropriate treatment that may prevent significant morbidity and mortality.
背景
血清素综合征是一种潜在的危及生命的综合征，由使用血清素能药物以及外周和中枢突触后5HT - 1A受体，尤其是5HT - 2A受体的过度激活所引发。该综合征包括精神状态改变、神经肌肉活动亢进和自主神经活动亢进的综合表现。血清素综合征可单独通过血清素能药物的治疗性使用、血清素能药物的故意过量服用而发生，或者典型地，是由于两种作用机制不同的血清素能药物之间复杂的药物相互作用所致。多种药物组合都可能导致血清素综合征。
方法
本综述描述了血清素综合征的表现及管理，并讨论了可引发该综合征的药物及相互作用，目的是使医生对这种潜在致命但可预防的综合征更加警觉并有所认识。
结论
许多常用药物已被证实是血清素综合征的罪魁祸首。对血清素综合征进行适当的教育和认识将提高诊断的准确性，并促进采取适当的治疗措施，从而可能预防严重的发病率和死亡率。
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