アブストラクト
| Title | 第8回 向精神薬と体温 - 悪性症候群とセロトニン症候群 - |
|---|---|
| Subtitle | 連載企画 連載講座 内科医がいない単科病院で働く君のために「精神科医の身体管理」 |
| Authors | 長嶺敬彦 |
| Authors (kana) | |
| Organization | 三光舎 (Sunlight Brain Research Center) |
| Journal | 精神科 Resident |
| Volume | 3 |
| Number | 3 |
| Page | 205-213 |
| Year/Month | 2022 / |
| Article | 報告 |
| Publisher | 先端医学社 |
| Abstract | 「Key Takeaways」 ●抗精神病薬のα1遮断作用は軽度だが体温を低下させる ●偶発性低体温は, 32℃以下では高次医療機関へ搬送する ●抗精神病薬は, 免疫系に作用し, サイトカイン産生を介して高熱を起こすことがある ●薬剤性発熱と悪性症候群(NMS)は, 厳密には区別できない ●セロトニン作動薬の使用頻度が増加し, セロトニン症候群(SS)は増加傾向にある ●NMSもSSも, MMHAの4症状が診断に重要である(M:mental status change, M:muscular rigidity, H:hyperthermia, A:autonomic instability) ●NMSとSSの鑑別で重要なのは筋症状である(NMSは固縮で, SSはミオクローヌス) 「はじめに」 精神科臨床では, 体温の著しい異常に注意しなければならない. 向精神薬は中枢に作用する薬であり, 視床下部に存在する体温調節中枢に影響する. |
| Practice | 臨床医学：一般 |
| Keywords |
- 全文ダウンロード： 従量制、基本料金制の方共に896円(税込) です。
参考文献
- 1) Nagamine T:Complete recovery from cardiac arrest caused by risperidone-induced hypothermia. Innov Clin Neurosci 13:28-31,2016
- 2) Nagamine T:How to facilitate respiratory rate mea-surement in the emergency room. Ipn J Nurs Sci:e12493,2022. Online ahead of print
- 3) Nagamine T:Antipsychotic-induced hyperthermia in patients with behavioral and psychological symp-toms of dementia. Clin Neuropsychopharmacol Ther 3:5-7,2012
- 4) Stuhec M:Clozapine-induced elevated C-reactive protein and fever mimic infection. Gen Hosp Psychia-try 35:680.e5-6,2013
- 5) Jeong SH, Ahn YM, Koo YJ et al:The characteristics of clozapine-induced fever. Schizophr Res 56:191-193,2002
残りの15件を表示する
- 6) Netea MG, Kullberg BJ, Van der Meer JW:Circulat-ing cytokines as mediators of fever. Clin Infect Dis Suppl 5:S178-S184,2000
- 7) Hung YP, Wang CS, Yen CN et al:Role of cytokine changes in clozapine-induced fever:a cohort pro-spective study. Psychiatry Clin Neurosci 71:395-402,2017
- 8) Bruno V, Valiente-Gomez A, Alcoverro O:Clozapine and fever:a case of continued therapy with clozap-ine. Clin Neuropharmacol 38:151-153,2015
- 9) Nagamine T:Beware of neuroleptic malignant syn-drome in COVID-19 pandemic. Innov Clin Neurosci 18:9-10,2021
- 10) Nagamine T:Neuroleptic malignant syndrome asso-ciated with COVID-19 vaccination. CJEM 24:349-350,2022
- 11) Espiridion ED, Mani V, Oladunjoye AO:Neuroleptic malignant syndrome after re-introduction of atypical antipsychotics in a COVID-19 patient. Cureus 13:e13428,2021
- 12) Caroff SN, Mann SC:Neuroleptic malignant syn-drome. Med Clin North Am 77:185-202,1993
- 13) Nagamine T:Beware of serotonin syndrome during the COVID-19 pandemic. Aust N Z J Psychiatry 56:862,2022
- 14) Sternbach H:The serotonin syndrome. Am J Psychi-atry 148:705-713,1991
- 15) Nagamine T:Neuroleptic malignant syndrome or serotonin syndrome? Psychiatr Danub. In press
- 16) Prakash S, Adroja B, Rathore C:Neuromuscular abnormalities in serotonin syndrome may be mis-taken as seizure:a report and literature review. Neurol India 67:269-271,2019
- 17) Boudier-Reveret M, Chang MC:Serotonin syndrome in a patient with chronic pain taking analgesic drugs mistaken for psychogenic nonepileptic seizure:a case report. Yeungnam Univ J Med 38:371-373,2021
- 18) Nevels RM, Gontkovsky ST, Williams BE:Paroxe-tine-the antidepressant from hell? Probably not, but caution required. Psychopharmacol Bull 46:77-104,2016
- 19) Nagamine T:Beware of serotonin overload in phar-macotherapy for elderly patients with burning mouth syndrome. Psychogeriatrics 22:423-424,2022
- 20) Debeljak T, Kores Plesnicar B:Distinguishing between neuroleptic malignant syndrome and sero-tonin syndrome in polypharmacy:an overview with a case report. Psychiatr Danub 33(Suppl 4):1227-1229,2021
