Diagnosis and treatment of drug-induced hyperthermia

Musselman, Megan E.; Saely, Suprat

doi:10.2146/ajhp110543

Cited by 55 publications

(25 citation statements)

References 54 publications

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“…The mainstay of treatment in hyperthermic conditions includes withdrawal of triggers, supportive therapy with cooling techniques and pharmacotherapy aimed at reducing core body temperature [3]- [7]. Among the few pharmacological options available dantrolene a drug used in the treatment of MH may be beneficial in several hyperthermic conditions [10]- [13].…”

Section: Introductionmentioning

confidence: 99%

Dantrolene in the Treatment of Refractory Hyperthermic Conditions in Critical Care: A Multicenter Retrospective Study

Pawar¹,

Rosenberg²,

Adamson³

et al. 2015

OJAnes

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Purpose: To examine the use of intravenous dantrolene in hospitalized patients. Materials and Methods: Medical Records of patients treated with intravenous dantrolene between 2007 and 2012 at 6 teaching hospitals were reviewed. Temperature, muscle rigidity, creatine kinase levels, and mortality were assessed in association with dantrolene use. Results: Twenty-five patients received intravenous dantrolene, 9 patients with neuroleptic malignant syndrome (NMS), 8 with hyperthermia due to sepsis, 4 with NMS and sepsis, 2 for malignant hyperthermia (MH), and 2 with hypermetabolic syndrome associated with juvenile diabetic ketoacidosis. Dantrolene was administered as a bolus of 1 -3 mg/kg. Core temperature decreased after dantrolene administration in all groups but significant only for MH, NMS cases (Pre 102.3 ± 0.9˚F vs. Post 99.5 ± 0.9˚F; p < 0.001), in Sepsis cases (Pre 104.3 ± 1.5˚F vs. Post 100.6 ± 1.0˚F; p < 0.001). Mean rigidity scores decreased in all groups but significant only for NMS cases, and mean CK did not change significantly in any group. Conclusion: Dantrolene was associated with reductions in temperature and rigidity in hyperthermia of diverse origins in patients admitted to Intensive care settings.

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Section: Introductionmentioning

confidence: 99%

Dantrolene in the Treatment of Refractory Hyperthermic Conditions in Critical Care: A Multicenter Retrospective Study

Pawar¹,

Rosenberg²,

Adamson³

et al. 2015

OJAnes

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“…This is especially true for patients who received long-acting depot formulations. 1,4,5,10,11 Once there is a high clinical suspicion of NMS, immediate discontinuation of the offending agent(s) is vital. The use of additional therapy is supportive with a primary goal of managing the untoward effects of NMS as a whole.…”

Section: Discussionmentioning

confidence: 99%

“…Enteral administration of dopaminergic agents, bromocriptine (2.5 mg 2-3 times daily) or amantadine (200-400 mg/ day in divided doses), have been reported to reverse parkinsonian symptoms, hasten the speed of recovery, and reduce mortality rates. 10,11,13 However, cautious use of bromocriptine is recommended because it has been shown to induce psychosis, hypotension, and vomiting. • Severe cases (defined as rigidity; catatonia or coma; temperature ≥40°C; and/or heart rate ≥120 bpm): For patients with severe NMS or for those patients in whom use of the previously mentioned agents is not ideal, dantrolene should be considered.…”

Section: Discussionmentioning

confidence: 99%

Antipsychotic-Induced Neuroleptic Malignant Syndrome After Cardiac Surgery

Moll

Ward

Zivot³

2016

A & A Case Reports

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We report a case of neuroleptic malignant syndrome (NMS) in a postoperative cardiac surgery patient after the administration of typical and atypical antipsychotics for the treatment of delirium. On postoperative day 8, the patient's temperature peaked at 40.6°C. Agitation, rigidity, elevation in creatine kinase, and leukocytosis were associated findings. NMS was suspected on postoperative day 10. All antipsychotics were discontinued; dantrolene infusions and fluid therapy were initiated. After 2 days of NMS treatment, the patient's symptoms resolved. The temporal relationship between discontinuation of all antipsychotics, initiation of dantrolene, and clinical improvement supports the diagnosis of antipsychotic-induced NMS.

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“…Serotonin syndrome is a clinical diagnosis, but the Hunter criteria are valuable, being 84% sensitive, and 97% specific. Serotonin syndrome may develop within minutes or hours of starting the culprit drug, 18 distinguishing it from NMS. Patients may become hyperpyrexic in life-threatening cases.…”

Section: Serotonin Syndromementioning

confidence: 99%

Drug-induced hyperthermia in critical care

Walter

Carraretto

2015

Journal of the Intensive Care Society

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Fever is common in critically ill patients and the cause is frequently not infection. Drug fevers occur in the intensive care and there are many pharmacological agents, by a variety of mechanisms, which increase body temperature beyond normal range. This article is a review of the common classes of drugs that can induce hyperthermia, highlighting the deleterious effects of a sustained high temperature and outlining available treatments.

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Diagnosis and treatment of drug-induced hyperthermia

Abstract: DIH is a hypermetabolic state caused by medications and other agents that alter neurotransmitter levels. The treatment of DIH syndromes includes supportive care and pharmacotherapy as appropriate.

Cited by 55 publications

References 54 publications

Dantrolene in the Treatment of Refractory Hyperthermic Conditions in Critical Care: A Multicenter Retrospective Study

Dantrolene in the Treatment of Refractory Hyperthermic Conditions in Critical Care: A Multicenter Retrospective Study

Antipsychotic-Induced Neuroleptic Malignant Syndrome After Cardiac Surgery

Drug-induced hyperthermia in critical care

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