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Re: Olanzapine and side effects » Sunnely

Posted by SLS on December 4, 2000, at 22:05:33

In reply to Re: Olanzapine and side effects » SLS, posted by Sunnely on December 4, 2000, at 19:46:08

Sunnely - Thank you for contributing another one of your thoroughly informative replies.

There is an obvious similarity in the presentation of NMS with serotonin syndrome. How are they differentially diagnosed?

Thanks again.


- Scott

> The 4 cardinal clinical features of a full-blown NMS are: 1) Hyperthermia (markedly elevated body temperature, 104 F or higher); 2) Muscular rigidity (e.g., "lead-pipe" rigidity; patient can't move, can't talk, can't swallow); 3) Autonomic instability (e.g., blood pressure fluctuating, rapid pulse, rapid respiration, profuse sweating, incontinence); and 4) Altered consciousness (e.g., confusion, agitation, mute, frightened facial expression, lethargic, stuporous, delirious). Although not diagnostic of NMS, in one study, 92% of patients who developed NMS had elevated levels of CPK (creatine phosphokinase). CPK is a muscle enzyme and a sensitive marker of muscle injury (e.g. marked muscular rigidity). Death from NMS is usually due to acute kidney failure or aspiration pneumonia.

 

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