Probable Case of Neuroleptic Malignant Syndrome Following Administration of Antituberculotic Drugs in a Chlorpromazine-Treated Patient

Shim, Geumsook; Kang, Do Hyung; Kwon, Jun Soo

doi:10.3346/jkms.2008.23.4.734

Cited by 6 publications

(5 citation statements)

References 12 publications

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“…15 Chlorpromazine has been shown to induce NMS when used alone 16,17 or with other drugs. 18,19 Haloperidol is another FGA that blocks dopamine receptors D1 and D2 in the brain. 20 Haloperidol is a highly potent AP and has been implicated in many cases of NMS.…”

Section: Discussionmentioning

confidence: 99%

A Case Report of Probable Neuroleptic Malignant Syndrome

McCullough

Stroup

Brahm

2013

Journal of Pharmacy Technology

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Objective: To report a case of probable neuroleptic malignant syndrome (NMS) of unknown origin. Case Summary: A 32-year-old Caucasian man was found unconscious by emergency services. On presentation to the emergency department, he had a temperature of 107.5°F (41.9°C) and a Glasgow Coma Scale rating of 3 (range = 3-15). Fluids were administered and cooling blankets applied. He was admitted to the intensive care unit. Supportive measures decreased his temperature to 101.7°F (38.7°C). Arterial blood gas, comprehensive metabolic panel, complete blood count, and cardiac risk panel results were within normal limits; urinalysis and urine and serum drug screens were negative. He had been discharged on the following medications: benztropine, citalopram, chlorpromazine, divalproex, haloperidol, and hydroxyzine. Based on the medication discharge list and clinical presentation, the Naranjo Adverse Drug Reaction Probability Scale was applied. The criteria scoring indicated a probable relationship (8 of 12) between the medications prescribed and symptoms consistent with NMS. Discussion: NMS has been reported with antipsychotics (APs) and other medications with dopaminergic activity. The etiology is poorly understood. Risk factors (ie, recent initiation or dose increase of an AP, dehydration, or genetic susceptibility) may increase the potential. The differentiation between the diagnosis of NMS and other factors, such as serotonin syndrome or hyperthermia, includes laboratory and clinical presentation characteristics. The potential contributions of anticholinergic agents, psychiatric comorbidities, and other risk factors were identified for this patient. Conclusions: We report the case of a patient found unresponsive and comatose. A variety of assessment measures were used to identify potential causes. Based on evaluations, clinical presentation, the medication list, and criteria for an adverse drug event, a diagnosis of NMS was given. Health care providers may not be fully aware of the potential severity for this medication-related effect in patients with multiple risk factors.

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Section: Discussionmentioning

confidence: 99%

A Case Report of Probable Neuroleptic Malignant Syndrome

McCullough

Stroup

Brahm

2013

Journal of Pharmacy Technology

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“…The spectrum of drugs susceptible to DDIs with rifampicin includes cyclosporine (41), mycophenolate (42), glucocorticoids (43), and antifungal agents (44). Other clinically significant effects included neuroleptic malignant syndrome resulting from cholinergic hyperactivity similar to as seen in cases of neuroleptic malignant syndrome after abrupt cessation of antipsychotic medication (46). In all cases, CYP3A4 induction resulted in decreased concentrations of the coadministered drug resulting in decreased therapeutic effect (41)(42)(43)(44)(45)(46)(47).…”

Section: Nontuberculous Antimycobacterial Drugsmentioning

confidence: 92%

“…Rifampin is a known potent CYP3A4 inducer with a large number of documented DDIs. In all cases, CYP3A4 induction resulted in decreased concentrations of the coadministered drug resulting in decreased therapeutic effect (41)(42)(43)(44)(45)(46)(47). As outlined in Table 3, DDIs between rifampicin and psychiatric medications have been reported with TCAs (45), chlorpromazine (46), and citalopram (47).…”

Section: Nontuberculous Antimycobacterial Drugsmentioning

confidence: 99%

“…The spectrum of drugs susceptible to DDIs with rifampicin includes cyclosporine (41), mycophenolate (42), glucocorticoids (43), and antifungal agents (44). As outlined in Table 3, DDIs between rifampicin and psychiatric medications have been reported with TCAs (45), chlorpromazine (46), and citalopram (47). In all cases, CYP3A4 induction resulted in decreased concentrations of the coadministered drug resulting in decreased therapeutic effect (41)(42)(43)(44)(45)(46)(47).…”

Section: Nontuberculous Antimycobacterial Drugsmentioning

confidence: 99%

“…As outlined in Table 3, DDIs between rifampicin and psychiatric medications have been reported with TCAs (45), chlorpromazine (46), and citalopram (47). In all cases, CYP3A4 induction resulted in decreased concentrations of the coadministered drug resulting in decreased therapeutic effect (41)(42)(43)(44)(45)(46)(47). Other clinically significant effects included neuroleptic malignant syndrome resulting from cholinergic hyperactivity similar to as seen in cases of neuroleptic malignant syndrome after abrupt cessation of antipsychotic medication (46).…”

Section: Nontuberculous Antimycobacterial Drugsmentioning

confidence: 99%

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The clinical significance of drug interactions between dermatological and psychoactive medications

Frew

2014

Dermatol Ther

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Dermatological disease is commonly associated with psychological morbidity because of its visible nature. The burden of living with a chronic dermatological illness can contribute to the development of psychiatric illness and conversely, such conditions can result in the exacerbation of preexisting dermatological disease. It may also reduce a patient's compliance to treatment, result in loss to follow-up and a decreased level of functioning and quality of life. In dermatological patients who suffer from psychiatric symptoms, medical management used in their treatment may have significant interactions with systemic medications used to treat their dermatological condition. A well-known example of this is lithium's ability to exacerbate psoriasis. Such interactions can result in suboptimal treatment of their psychiatric and/or dermatological condition. The present paper aimed to review the literature for documented interactions and the level of clinical significance between dermatological and psychoactive medications. Such information is clinically relevant to the practicing dermatologist in order to minimize adverse effects and drug-drug interactions in dermatological patients.

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Current awareness: Pharmacoepidemiology and drug safety

2009

Pharmacoepidemiology and Drug

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In order to keep subscribers up‐to‐date with the latest developments in their field, John Wiley & Sons are providing a current awareness service in each issue of the journal. The bibliography contains newly published material in the field of pharmacoepidemiology and drug safety. Each bibliography is divided into 23 sections: 1 Reviews; 2 General; 3 Anti‐infective Agents; 4 Cardiovascular System Agents; 5 CNS Depressive Agents; 6 Non‐steroidal Anti‐inflammatory Agents; 7 CNS Agents; 8 Anti‐neoplastic Agents; 9 Haematological Agents; 10 Neuroregulator‐Blocking Agents; 11 Dermatological Agents; 12 Immunosuppressive Agents; 13 Autonomic Agents; 14 Respiratory System Agents; 15 Neuromuscular Agents; 16 Reproductive System Agents; 17 Gastrointestinal System Agents; 18 Anti‐inflammatory Agents ‐ Steroidal; 19 Teratogens/fetal exposure; 20 Antidiabetic Agents; 21 Contrast Agents; 22 Bone Conservation Agents; 23 Others. Within each section, articles are listed in alphabetical order with respect to author. If, in the preceding period, no publications are located relevant to any one of these headings, that section will be omitted.

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Probable Case of Neuroleptic Malignant Syndrome Following Administration of Antituberculotic Drugs in a Chlorpromazine-Treated Patient

Cited by 6 publications

References 12 publications

A Case Report of Probable Neuroleptic Malignant Syndrome

A Case Report of Probable Neuroleptic Malignant Syndrome

The clinical significance of drug interactions between dermatological and psychoactive medications

Current awareness: Pharmacoepidemiology and drug safety

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