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本文引用的文献

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A retrospective analysis of cases with neuroleptic malignant syndrome and an evaluation of risk factors for mortality.对神经阻滞剂恶性综合征病例的回顾性分析及死亡危险因素评估。
Turk J Emerg Med. 2017 Nov 27;17(4):141-145. doi: 10.1016/j.tjem.2017.10.001. eCollection 2017 Dec.
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Pharmacological management of anticholinergic delirium - theory, evidence and practice.抗胆碱能性谵妄的药物治疗——理论、证据与实践
Br J Clin Pharmacol. 2016 Mar;81(3):516-24. doi: 10.1111/bcp.12839. Epub 2015 Dec 29.
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Prevalence of Rhabdomyolysis in Sympathomimetic Toxicity: a Comparison of Stimulants.拟交感神经毒性中横纹肌溶解的患病率:兴奋剂的比较
J Med Toxicol. 2015 Jun;11(2):195-200. doi: 10.1007/s13181-014-0451-y.
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Serotonin syndrome.血清素综合征
BMJ. 2014 Feb 19;348:g1626. doi: 10.1136/bmj.g1626.
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Neuroleptic malignant syndrome: mechanisms, interactions, and causality.神经阻滞剂恶性综合征:机制、相互作用和因果关系。
Mov Disord. 2010 Sep 15;25(12):1780-90. doi: 10.1002/mds.23220.
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Bench-to-bedside review: mechanisms and management of hyperthermia due to toxicity.从 bench 到床边的综述:毒性所致高热的机制与管理
Crit Care. 2007;11(6):236. doi: 10.1186/cc6177.
7
The evaluation and management of patients with neuroleptic malignant syndrome.抗精神病药恶性综合征患者的评估与管理
Neurol Clin. 2004 May;22(2):389-411. doi: 10.1016/j.ncl.2003.12.006.
8
Moclobemide poisoning: toxicokinetics and occurrence of serotonin toxicity.吗氯贝胺中毒:毒代动力学及5-羟色胺毒性的发生情况
Br J Clin Pharmacol. 2003 Oct;56(4):441-50. doi: 10.1046/j.1365-2125.2003.01895.x.
9
The Hunter Serotonin Toxicity Criteria: simple and accurate diagnostic decision rules for serotonin toxicity.亨特血清素毒性标准:用于血清素毒性的简单准确的诊断决策规则。
QJM. 2003 Sep;96(9):635-42. doi: 10.1093/qjmed/hcg109.
10
Drug-induced hyperthermia and muscle rigidity: a practical approach.药物性高热与肌肉强直:一种实用方法
Eur J Emerg Med. 2003 Jun;10(2):149-54. doi: 10.1097/00063110-200306000-00018.

发热患者:急性药物性高热

The hot patient: acute drug-induced hyperthermia.

作者信息

Jamshidi Nazila, Dawson Andrew

机构信息

Royal Prince Alfred Hospital, Sydney.

NSW Poisons Information Centre, Sydney Children's Hospital Network.

出版信息

Aust Prescr. 2019 Feb;42(1):24-28. doi: 10.18773/austprescr.2019.006. Epub 2019 Feb 1.

DOI:10.18773/austprescr.2019.006
PMID:30765906
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6370613/
Abstract

Drugs can cause dysregulation of the hypothalamic–pituitary–adrenal axis which can result in a rise in core temperature. This type of hyperthermia is unresponsive to antipyretics and can be complicated by rhabdomyolysis, multi-organ failure and disseminated intravascular coagulation Organic causes of fever such as infection must be ruled out. Syndromes associated with drug-induced fever include neuroleptic malignant syndrome and anticholinergic, sympathomimetic and serotonin toxicity The class of offending drugs, as well as the temporal relationship to starting or stopping them, assists in differentiating between neuroleptic malignant syndrome and serotonin toxicity Immediate inpatient management is needed. The mainstay of management is stopping the drug, and supportive care often in the intensive care unit

摘要

药物可导致下丘脑 - 垂体 - 肾上腺轴功能失调,进而引起核心体温升高。这种类型的高热对抗热药物无反应,可能并发横纹肌溶解、多器官功能衰竭和弥散性血管内凝血。必须排除感染等发热的器质性病因。与药物性发热相关的综合征包括抗精神病药物恶性综合征以及抗胆碱能、拟交感神经和5-羟色胺毒性反应。引起问题的药物类别以及与开始或停用这些药物的时间关系,有助于区分抗精神病药物恶性综合征和5-羟色胺毒性反应。需要立即进行住院治疗。治疗的主要方法是停用药物,并通常在重症监护病房进行支持性护理。