Comments on: Irukandji syndrome http://lifeinthefastlane.com/2008/12/irukandji-syndrome/ Emergency Medicine education blog Wed, 23 May 2012 07:52:35 +0000 hourly 1 http://wordpress.org/?v=3.3.2 By: Chris Nicksonhttp://lifeinthefastlane.com/2008/12/irukandji-syndrome/#comment-28237 Chris Nickson Thu, 10 May 2012 11:05:55 +0000 http://sandnsurf.medbrains.net/?p=1380#comment-28237 Fentanyl has these favourable characteristics: potent rapid onset can be rapidly titrated preserves cardiac stability and blunts stress-related hormonal changes at higher doses rarely elicits histamine release no toxic metabolitesBlood pressure is often sufficiently well controlled with fentanyl alone (through analgesic and possibly sympatholytic effects), but the alpha-blockade effect of promethazine (or chlorpromazine which has been as an alternative) or the antihypertensive effects of GTN (rapidly titratable) and magnesium combine tend to do the job.Chris Fentanyl has these favourable characteristics:
potent
rapid onset
can be rapidly titrated
preserves cardiac stability and blunts stress-related hormonal changes at higher doses
rarely elicits histamine release
no toxic metabolites

Blood pressure is often sufficiently well controlled with fentanyl alone (through analgesic and possibly sympatholytic effects), but the alpha-blockade effect of promethazine (or chlorpromazine which has been as an alternative) or the antihypertensive effects of GTN (rapidly titratable) and magnesium combine tend to do the job.

Chris

]]> By: Mark Putlandhttp://lifeinthefastlane.com/2008/12/irukandji-syndrome/#comment-28086 Mark Putland Wed, 09 May 2012 11:19:19 +0000 http://sandnsurf.medbrains.net/?p=1380#comment-28086 I am curious. Why fentanyl when morphine has more vasodilation as a side effect and the patient is in the grip of a hypertensive crisis? I am curious. Why fentanyl when morphine has more vasodilation as a side effect and the patient is in the grip of a hypertensive crisis?

]]> By: Irukandji syndrome: a superb review article | The Poison Reviewhttp://lifeinthefastlane.com/2008/12/irukandji-syndrome/#comment-27695 Irukandji syndrome: a superb review article | The Poison Review Sat, 05 May 2012 17:15:11 +0000 http://sandnsurf.medbrains.net/?p=1380#comment-27695 [...] “Irukandji syndrome” can be caused by the sting of a number of jellyfish, predominantly Carukia barnesi.  This tiny (20 mm) cnidarian is found in the waters off northern Australia. Its sting initially seems minor, but is followed within 30 minutes to an hour with severe manifestations of catecholamine storm: hypertension, tachycardia,  EKG changes, and occasionally cardiomyopathy (Takutsubo). [...] [...] “Irukandji syndrome” can be caused by the sting of a number of jellyfish, predominantly Carukia barnesi.  This tiny (20 mm) cnidarian is found in the waters off northern Australia. Its sting initially seems minor, but is followed within 30 minutes to an hour with severe manifestations of catecholamine storm: hypertension, tachycardia,  EKG changes, and occasionally cardiomyopathy (Takutsubo). [...]

]]> By: Accidents liés aux animaux marins – 1 – méduses « thoracotomiehttp://lifeinthefastlane.com/2008/12/irukandji-syndrome/#comment-26442 Accidents liés aux animaux marins – 1 – méduses « thoracotomie Wed, 25 Apr 2012 07:53:48 +0000 http://sandnsurf.medbrains.net/?p=1380#comment-26442 [...] Irukandji syndrome, M. Cadogan, Life in the fast lane [...] [...] Irukandji syndrome, M. Cadogan, Life in the fast lane [...]

]]> By: Irukandji syndrome – the swarm hits Broome | Broome Docshttp://lifeinthefastlane.com/2008/12/irukandji-syndrome/#comment-21984 Irukandji syndrome – the swarm hits Broome | Broome Docs Sat, 21 Jan 2012 22:02:22 +0000 http://sandnsurf.medbrains.net/?p=1380#comment-21984 [...] Mike’s original post with links from 2008 [...] [...] Mike’s original post with links from 2008 [...]

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