DIAGNOSIS DAN TATA LAKSANA DINI SINDROM SEROTONIN BERAT
Abstract
Sindrom serotonin merupakan reaksi obat merugikan yang berpotensi mengancam jiwa akibat penggunaan obat agen serotonergik. Obat yang dapat menyebabkan sindrom serotonin adalah obat yang biasa digunakan dalam praktek klinis, termasuk analgetik golongan opioid dan anti emetik. Obat serotonergik dapat menyebabkan sindrom serotonin baik oleh penggunaan secara tunggal maupun kombinasi beberapa obat dengan dosis terapeutik. Dilaporkan kasus sindrom serotonin berat pada pasien paska operasi Seksio Cesarea dengan dengan riwayat penggunaan agen serotonergik antiemetik ondansetron dan analgetik opioid fentanyl dan petidin dengan dosis terapeutik, yang memerlukan perawatan intensif (ICU).Telah dilaporkan sebuah kasus keberhasilan penatalaksanaan Sindrom serotonin berat yang diduga akibat kombinasi obat serotonergik Ondansetron dan opioid serotonergik Fentanyl dan Petidin di ICU. Diharapkan para dokter terutama dokter spesialis anestesi dan intensivist mengenali gejala, penyebab dan kriteria diagnostik sindrom serotonin serta mampu melakukan tatalaksana cepat dan tepat pada sindrom serotonin untuk mempercepat resolusi dan mencegah komplikasi.
References
Scotton et al. Serotonin Syndrome: Pathophysiology, Clinical Features, Management, and Potential Future Directions. Int Journal of Tryptophan Research. 2019;12: 1–14.
Baldo BA, Rose MA. The anaesthetist, opioid analgesic drugs, and serotonin toxicity: a mechanistic and clinical review. BJA, 2020;124 (1): 44-62.
Rastogi R et al. Case Scenario: Opioid Association with Serotonin Syndrome Implications to the Practitioners. Am Society of Anesth, 2011;115:1291– 8.
Boyer EW, Shannon M. The serotonin syndrome. N Engl J Med. 2005;352:1112-20.
Buckley NA, Dawson AH, Isbister GK. Serotonin syndrome. BMJ. 2014;348:g1626.
Culbertson VL, Rahman SE, Bosen GC, Caylor ML, Echevarria MM, Xu D. Implications of off-target serotoninergic drug activity: an analysis of serotonin syndrome reports using a systematic bioinformatics approach. Pharmacotherapy. 2018;38:888-898.
Saper CB. Brainstem modulation of sensation, movement, and consciousness. In: Kandel ER, Schwartz JH, Jessell TM, eds. Principles in Neural Science. 4th ed. New York: McGraw-Hill; 2000:896.
Isbister GK, Buckley NA: The pathophysiology of serotonin toxicity in animals and humans: Implications for diagnosis and treatment. Clin Neuropharmacol 2005; 28:205–14.
Pilgrim JL, Gerostamoulos D, Drummer OH: Review: Pharmacogenetic aspects of the effect of cytochrome P450 polymorphisms on serotonergic drug metabolism, response, interactions, and adverse effects. Forensic Sci Med Pathol. 2011; 7:162– 84.
Gillman PK: Serotonin syndrome: History and risk. Fundam Clin Pharmacol 1998; 12:482–91.
Ables AZ, Nagubilli R: Prevention, recognition, and management of serotonin syndrome. Am Fam Physician 2010; 81:1139 – 42.
Ener RA, Meglathery SB, Van Decker WA, Gallagher RM: Serotonin syndrome and other serotonergic disorders. Pain Med 2003; 4:63–74
Radomski JW, Dursun SM, Reveley MA, Kutcher SP: An exploratory approach to the serotonin syndrome: An update of clinical phenomenology and revised diagnostic criteria. Med Hypotheses 2000; 55:218 –24
Summary safety review-serotonin blocking drugs (serotonin antagonists) Aloxi (palonosetron), Anzemet (dolasetron), Kytril(granisetron) and generics, and Zofran (ondansetron) and generics- Serotonin Syndrome. Available at: http://www.hc-sc.gc.ca/ dhp-mps/medeff/advisories-avis/review-examen/serotonin-eng.php. Accessed May 29th 2014.
WHO pharmaceutical newsletter: ondansetron and serotonin syndrome. 2012;3:16–21.
Once an article was published in the journal, the author(s) are: granted to the journal right licensed under Creative Commons License Attribution that allows others to share the work with an acknowledgement of the work's authorship. permitted to publish their work online in third parties as it can lead wider dissemination of the work. continue to be the copyright owner and allow the journal to publish the article with the CC BY-NC-SA license receiving a DOI (Digital Object Identifier) of the work.
