adrenergic_storm
Table of Contents
adrenergic storm
see also:
Introduction
- an adrenergic storm is a potentially life threatening sudden increase in serum levels of the catecholamines, mainly, epinephrine and norepinephrine
- see also sudden transient surges in BP
Aetiology
- cocaine overdose
- metamphetamine / meth / ice overdose
-
- at induction of anaesthesia
- on squeezing the tumour in surgery, or during straining, labour, fetal movements, etc
Differential diagnosis
- panic attack
Clinical features
- tachycardia
- hypertension
- anxiety
- tachypnoea
- hyperkinetic movements
- possible hyperthermia, mania, delirium, cardiac arrhythmias, rhabdomyolysis, stroke (CVA), acute myocardial infarction (AMI/STEMI/NSTEMI), catecholamine induced cardiomyopathy
Mx
- treat the cause where possible
- cardiac monitor
- IV fluids
- supportive care
- benzodiazepines but avoid alprazolam as it weakly agonizes dopamine receptors and causes catecholamine release
- beta adrenergic blockers - non-selective beta blocker but avoid propranolol as it mildly promotes some catecholamine release - each worsening the condition
- antipsychotics if needed
adrenergic_storm.txt · Last modified: 2025/06/10 08:13 by gary1