Seretonin syndrome :
Diagnosis: tetrad of altered mental status, agitation, hyperreflexia, myocolunus & hyperthermia & autonomic dysfunction → ICU admission
Immediate measures
- Supplemental oxygen & assisted ventilation if needed.
- Hyperthermia → Submersion in an ice-water bath
Drug therapy
- First line: Benzodiazepines.
- Second line: Cyproheptadine (Triactin) Oral or by NGT
- Dosing:
- 12mg then 2mg/2hrs OR 4-8mg/6hrs till improvement
- Children:
- <2yrs: 0.06mg/kg/6h
- 2-6 yrs: 2mg/6hrs
- 7-14yrs: 4mg/6hrs
Alkalinization of the urine with NaHCO₃ reduces myoglobinuric renal failure in patients with high CPK
