下列哪項是血清素症候群(Serotonin Syndrome)的症狀?
Which of the following is a symptom of serotonin syndrome?
- AHyporeflexia and bradycardia反射低下和心搏過緩
- BUrinary retention and dry mouth尿滯留和口乾
- CHyperreflexia and tremors✓ 正解反射亢進和震顫
- DSevere muscle rigidity and high fever嚴重肌肉僵硬和高燒
血清素症候群(Serotonin Syndrome)是一種潛在危及生命的藥物不良反應,通常發生在病人服用過多血清素能藥物(serotonergic drugs)或合併使用多種增加血清素活性的藥物時。這些藥物包括選擇性血清素再吸收抑制劑(SSRIs)、血清素及正腎上腺素再吸收抑制劑(SNRIs)、單胺氧化酶抑制劑(MAOIs)、某些三環抗憂鬱劑(TCAs)、曲普坦類(triptans)、芬太尼(fentanyl)等。其症狀範圍廣泛,主要涉及精神狀態改變、自主神經功能亢進和神經肌肉異常。 正確答案 C 指出反射亢進(Hyperreflexia)和震顫(tremors),這是血清素症候群的典型神經肌肉症狀。其他常見症狀還包括躁動不安(agitation)、混亂(confusion)、瞳孔擴大(mydriasis)、出汗(diaphoresis)、腹瀉(diarrhea)、心跳過速(tachycardia)、高血壓(hypertension)和高熱(hyperthermia)。嚴重時可能導致癲癇、橫紋肌溶解(rhabdomyolysis)、腎衰竭和彌散性血管內凝血(DIC)。護理師必須能識別這些症狀,以便及早介入治療,避免病情惡化。
Serotonin syndrome is a potentially life-threatening adverse drug reaction that typically occurs when a client takes excessive serotonergic medications or combines multiple agents that increase serotonin activity. These drugs include selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), monoamine oxidase inhibitors (MAOIs), certain tricyclic antidepressants (TCAs), triptans, and fentanyl. Symptoms vary widely and primarily involve altered mental status, autonomic hyperactivity, and neuromuscular abnormalities. The correct answer C identifies hyperreflexia and tremors, which are classic neuromuscular manifestations of serotonin syndrome. Other common symptoms include agitation, confusion, mydriasis, diaphoresis, diarrhea, tachycardia, hypertension, and hyperthermia. In severe cases, complications such as seizures, rhabdomyolysis, renal failure, and disseminated intravascular coagulation (DIC) may occur. The nurse must be able to recognize these symptoms to initiate early intervention and prevent deterioration.