Team what's up, heck here we're back for another med geeks podcast so today we're going to discuss the last topic on our little toxicology series and that's going to be Saritonean syndrome. We'll go over a case, break it down by

intro, etiology, clinical presentation, work up diagnosis, differential, and lastly

management. So let us begin. So you have a 32 year old male with the past

medical history of depression presents with an intentional overdose of his

antidepressants. Per the family patient was found in his bedroom, acting abnormal, and there was an empty

bottle of Zoloff prescription on the bedroom floor. His last known normal was when he got home from work at 3 p.m.

which was about four hours prior to arrival to the ER.

So initial vitals revealed temperature of 103.9

heart rate in the 1 30s, BP 110 over 78, and oxygen

saturations of 96% on room air. So on exam he was very agitated and irritable. He appeared flush, sweaty, his pupils

were dilated. He had this indusible ankle clonous along with hyper reflexia of the lower extremities. So what are you thinking?

So first off, why do we care about serotonin syndrome? Well first off it can be fatal.

Second, you may never see it in your life as a provider but it is a clinical diagnosis

that if it does come along you don't want to miss it.

A. K. It should be on your differential and a patient who presents

with altered mental status agitated, they have some neuromuscular abnormality like Clonis or hyper reflexia and they do have a

serotonergic drug on their medication list. You need to know that serotonin

syndrome is a possibility

because the last thing you want to do is give the patient

a medication that will then worsen the symptoms.

So another agent that is serotonergic

because that can then be fatal. Also it can easily happen to any

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