SNRI Toxicity: Difference between revisions
Kghaffarian (talk | contribs) No edit summary |
Ostermayer (talk | contribs) (Text replacement - "Category:Tox" to "Category:Toxicology") |
||
| Line 36: | Line 36: | ||
*Mills K. Atypical Antidepressants, Serotonin Reuptake Inhibitors, and Serotonin Syndrome In: Tintinalli's Emergency Medicine. 7th ed. McGraw Hill. 2011:1198-2002 | *Mills K. Atypical Antidepressants, Serotonin Reuptake Inhibitors, and Serotonin Syndrome In: Tintinalli's Emergency Medicine. 7th ed. McGraw Hill. 2011:1198-2002 | ||
[[Category: | [[Category:Toxicology]] | ||
Revision as of 16:23, 22 March 2016
Background
- Inhibits reuptake of serotonin, norepinephrine and small effect on dopamine
- Examples: venlafaxine, duloxetine
- Adverse effects similar to SSRIs
- Venlafaxine (Effexor)
- Can produce mild to moderate hypertension
- Duloxetine (Cymbalta)
- Nausea, vomiting, dizziness
Clinical Features
- Sympathomimetic: tachycardia, hypertension, diaphoresis, tremor, mydriasis
- Secondary to inhibition of norepinephrine reuptake
- Sedation
- Seizures
- More common than with SSRI toxicity
- Rhabdomyolysis
- 25% occur without seizures
- ECG
- Most common abnormality: sinus tachycardia
- May see QRS widening or QT prolongation
Diagnosis
- Suggestive history with appropriate clinical features
Management
- Cardiac monitoring
- Supportive Care: IV fluids for hypotension, Benzodiapazines for seizures
- Consider single dose activated charcoal
Disposition
- Admit all symptomatic pts to a monitored bed
- Monitor for 6 hours, longer for extended-release preparations
See Also
References
- Mills K. Atypical Antidepressants, Serotonin Reuptake Inhibitors, and Serotonin Syndrome In: Tintinalli's Emergency Medicine. 7th ed. McGraw Hill. 2011:1198-2002