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Neuroleptic malignant syndrome — RCPSC EM MCQ

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HardPsychiatric emergenciesNeuroleptic malignant syndromeRCPSC EM

A patient taking sertraline develops agitation, diaphoresis, diarrhea, inducible clonus and hyperreflexia six hours after starting linezolid. Temperature is 39.4°C despite acetaminophen. What is the most appropriate next step?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: CStop serotonergic medicines and treat with benzodiazepines plus active cooling

Explanation lettering: C = shown as B · B = shown as C · E = shown as D · D = shown as E

B is correct for serotonin toxicity; benzodiazepines, cooling and withdrawal of serotonergic medicines address the physiology. C retains the interacting drug. D treats the wrong syndrome. E may aggravate thermoregulatory toxicity. A targets the opposite toxidrome.

Reference: Emergency Care BC, Serotonin Toxicity: https://emergencycarebc.ca/sim_cases/serotonin-toxicity/