Joe Soohyun, Kim Eunju, Park Junyi, Lee Dongwon, Son Jongchul, Kim Hyun
Department of Psychiatry, Bugok National Hospital, Changnyeong, Korea.
Department of Anesthesiology and Pain Medicine, Daegu Fatima Hospital, Daegu, Korea.
Korean J Anesthesiol. 2017 Apr;70(2):221-223. doi: 10.4097/kjae.2017.70.2.221. Epub 2017 Jan 11.
Serotonin syndrome is an unexpected fatal adverse event related to serotonergic medication. This case report is the first report describing the possible treatment effect of famotidine on serotonin syndrome. Furthermore, this is the first case report of serotonin syndrome induced by meperidine alone in a patient with no previous history suggesting a susceptibility to serotonin syndrome. A 70-year-old male with no recent history of serotonergic drug use presented with severe serotonin syndrome following ureteroscopy, possibly due to postoperative meperidine administration. The patient's symptoms included hypertension, tachycardia, tachypnea, hyperthermia, myoclonus, diaphoresis, retching, nausea, agitation, and semicoma mentality with no pupillary light reflex. Symptoms began to subside immediately after the administration of intravenous famotidine for prevention of aspiration pneumonia, with mental and neurological symptoms showing improvement initially, followed by autonomic symptoms. This case report suggests that the histamine type 2 receptor antagonist famotidine may be an effective emergency treatment for serotonin syndrome.
血清素综合征是一种与血清素能药物相关的意外致命不良事件。本病例报告是首份描述法莫替丁对血清素综合征可能治疗效果的报告。此外，这是首例仅由哌替啶诱发血清素综合征的病例报告，该患者既往无提示血清素综合征易感性的病史。一名近期无血清素能药物使用史的70岁男性在输尿管镜检查后出现严重血清素综合征，可能是由于术后使用了哌替啶。患者的症状包括高血压、心动过速、呼吸急促、高热、肌阵挛、多汗、干呕、恶心、躁动以及无瞳孔对光反射的半昏迷状态。在静脉注射法莫替丁以预防吸入性肺炎后，症状立即开始缓解，精神和神经症状最初有所改善，随后自主神经症状也有所改善。本病例报告表明，组胺2型受体拮抗剂法莫替丁可能是治疗血清素综合征的一种有效急救药物。
