Adverse drug reactions resulting in hyperthermia in the intensive care unit
- 1 June 2010
- journal article
- review article
- Published by Ovid Technologies (Wolters Kluwer Health) in Critical Care Medicine
- Vol. 38, S244-S252
- https://doi.org/10.1097/ccm.0b013e3181dda0d4
Abstract
Hyperthermia is frequently seen in the intensive care setting and is associated with significant morbidity and mortality. It is often initially misdiagnosed as fever associated with infection. Atypical presentations of classic syndromes are common. Clinical suspicion is the key to diagnosis. Adverse drug reactions are a frequent culprit. Syndromes include adrenergic "fever," anticholinergic "fever," antidopaminergic "fever," serotonin syndrome, malignant hyperthermia, uncoupling of oxidative phosphorylation, and withdrawal from baclofen. This review describes the pathophysiology of hyperthermia, as distinct from fever, and the physiology, diagnosis, and treatment of serotonin syndrome, neuroleptic malignant syndrome, malignant hyperthermia, and baclofen withdrawal. Much of the available evidence regarding the treatment of these disorders is based on single case reports, case series, or animal models. Therapeutic modalities consist of identification/withdrawal of possible offending agent(s), support directed at lowering temperature and preventing/treating complications, as well as targeted pharmacologic therapy directed at the specific cause. Early recognition and treatment using a multidisciplinary approach are essential to achieve the best possible outcome.This publication has 46 references indexed in Scilit:
- Physiology of ThermoregulationBest Practice & Research Clinical Anaesthesiology, 2008
- ThermoregulationNeurology, 2007
- Bench-to-bedside review: Mechanisms and management of hyperthermia due to toxicityCritical Care, 2007
- The Serotonin SyndromeThe New England Journal of Medicine, 2005
- 2002 annual report of the American association of poison control centers toxic exposure surveillance systemThe American Journal of Emergency Medicine, 2003
- Serotonin Syndrome Presentation of 2 Cases and Review of the LiteratureMedicine, 2000
- Practice parameters for evaluating new fever in critically ill adult patientsCritical Care Medicine, 1998
- THE SEROTONIN SYNDROMEEmergency Medicine Clinics of North America, 1997
- Serotonin SyndromeAnnals of Emergency Medicine, 1996
- Neurologic effects of tryptophan in patients receiving a monoamine oxidase inhibitorNeurology, 1960