AnatomyDiseasesChemicals and DrugsAnalytical, Diagnostic and Therapeutic Techniques and EquipmentPhenomena and ProcessesInformation Science
Muscle RigidityMalignant HyperthermiaHyperthermia, InducedNeuroleptic Malignant SyndromeMasseter MuscleSuccinylcholineAlfentanilAnestheticsHalothaneFentanylAnesthetics, LocalAnesthetics, InhalationMusclesAnesthetics, GeneralMuscle, SkeletalMuscle ProteinsMuscle, SmoothFeverAnesthetics, IntravenousMuscle Fibers, SkeletalIsofluraneMuscle ContractionMuscle, Smooth, VascularMyopathy, Central CoreEncyclopedias as TopicRhabdomyolysis
SuccinylcholineRhabdomyolysisTachycardiaLocal anestheticSusceptibilitySuspect malignant hyperthermiaDantroleneRyanodine receptorFeverHalothane2022SevereSerotonin SyndromeSkeletalAnesthesiaTemperatureRespiratoryExtrapyramidal SymptomsPatientsRelaxantRYR1SeizuresWeaknessComplicationsSusceptible individualsOccurDissociativePyrexiaHypothermiaRestlessnessTreatmentMutationsRapidFibersDiarrheaDiagnosisInjectionNitrous oxideAnalgesicGeneticCalcium ions within muscle cellsBreakdownDegreesPhenothiazinesDisorderFluidsIncludeGasesTardive dyskinesia
Succinylcholine8
  • Exposure to triggering agents (certain volatile anesthetic agents or succinylcholine) can lead to the development of MH in those who are susceptible. (wikipedia.org)
  • Malignant Hyperthermia (MH) is inherited genetic disorder found in an estimated 1 out of 2,000 people and triggered by certain anesthetics and/or the drug succinylcholine and most often experienced in individuals undergoing routine surgery but in rare cases MH can happen without anesthesia. (sciencedaily.com)
  • Malignant hyperthermia (MH) is a rare, inherited disorder of skeletal muscle that presents as a hypermetabolic response triggered by halogenated anesthetics, succinylcholine, or both. (medscape.com)
  • MH is an inherited disorder of skeletal muscle that classically presents itself as a hypermetabolic response to halogenated anesthetic agents, succinylcholine, or both. (medscape.com)
  • If an MH-susceptible patient receives a volatile anesthetic agent or succinylcholine, an MH reaction may be triggered. (medscape.com)
  • The earliest signs are tachycardia, rise in end-expired carbon dioxide concentration despite increased minute ventilation, accompanied by muscle rigidity, especially following succinylcholine administration. (wren-clothing.com)
  • Triggering Agents According to the Malignant Hyperthermia Association of the United States (MHAUS), the following agents approved for use in the U.S. are known triggers of MH: inhaled general anesthetics, halothane, desflurane, enflurane, ether, isoflurane, sevoflurane, and succinylcholine. (wren-clothing.com)
  • Malignant hyperthermia usually develops after a person receives a muscle relaxant (most often succinylcholine ) along with an anesthetic gas (most often halothane) for surgery. (msdmanuals.com)
Rhabdomyolysis6
  • The typical signs of malignant hyperthermia are due to a hypercatabolic state, which presents as a very high temperature, an increased heart rate and abnormally rapid breathing, increased carbon dioxide production, increased oxygen consumption, mixed acidosis, rigid muscles, and rhabdomyolysis. (wikipedia.org)
  • This is likely due to severe and prolonged hyperthermia, rhabdomyolysis, and acidosis [68]. (wren-clothing.com)
  • BACKGROUND: Patients susceptible to malignant hyperthermia (MH) may experience disabling manifestations of an unspecified myopathy outside the context of anesthesia, including myalgia, fatigue, or episodic rhabdomyolysis. (bvsalud.org)
  • If given these drugs, people at risk of malignant hyperthermia may experience muscle rigidity, breakdown of muscle fibers (rhabdomyolysis), a high fever (hyperthermia), increased acid levels in the blood and other tissues (acidosis), and a rapid heart rate. (medlineplus.gov)
  • Acute rhabdomyolysis with hyperkalemia followed by ventricular dysrhythmias, cardiac arrest, and death has occurred after use in apparently healthy pediatric patients who were subsequently found to have undiagnosed skeletal muscle myopathy. (nih.gov)
  • Physical restraint should be avoided if possible due to risks of rhabdomyolysis and hyperthermia. (medscape.com)
Tachycardia2
  • Signs and symptoms present as tachycardia. (otterbein.edu)
  • Hyperthermia can occur as early as 15 minutes after onset of MH, usually after hypercarbia and tachycardia appear. (wren-clothing.com)
Local anesthetic3
  • Chlopromazine is a potent local anesthetic. (biologydiscussion.com)
  • Prior to the surgery, the anesthesiologist is performing an ultrasound-guided interscalene nerve block when the patient suddenly loses consciousness and then develops cardiovascular collapse following the injection of the local anesthetic bupivacaine. (theanesthesiaconsultant.com)
  • Regional block resulting from an injection of a large volume of local anesthetic into the epidural space . (wikidoc.org)
Susceptibility9
  • In most people with malignant hyperthermia susceptibility, they have few or no symptoms unless they are exposed to a triggering agent. (wikipedia.org)
  • In fact, malignant hyperthermia susceptibility (MHS), predisposed by mutations in the skeletal muscle calcium release channel (RYR1), is one of the most severe heat-related illnesses. (wikipedia.org)
  • citation needed] There is mounting evidence that some individuals with malignant hyperthermia susceptibility may develop MH with exercise and/or on exposure to hot environments. (wikipedia.org)
  • Malignant hyperthermia may occur, especially in individuals with known or suspected susceptibility based on genetic factors or family history. (nih.gov)
  • Sevoflurane should not be used in patients with known or suspected genetic susceptibility to malignant hyperthermia. (medicines.org.uk)
  • BACKGROUND: Most patients with malignant hyperthermia susceptibility diagnosed by the in vitro caffeine-halothane contracture test (CHCT) develop excessive force in response to halothane but not caffeine (halothane-hypersensitive). (bvsalud.org)
  • By measuring sensitivity to halothane of myotubes and extending clinical observations and cell-level studies to a large group of patients, we reach new insights into the pathological mechanism of malignant hyperthermia susceptibility. (bvsalud.org)
  • METHODS: Patients with malignant hyperthermia susceptibility were classified into subgroups HH and HS (positive to halothane only and positive to both caffeine and halothane). (bvsalud.org)
  • Susceptibility to malignant hyperthermia is an inherited genetic trait that runs in families. (msdmanuals.com)
Suspect malignant hyperthermia2
Dantrolene6
  • Our study indicates that requiring ambulatory surgery centers to stockpile Dantrolene as recommended by Malignant Hyperthermia Association of the United States (MHAUS) is a cost-effective measure for treating malignant hyperthermia -- an infrequent but potentially fatal complication. (sciencedaily.com)
  • The Malignant Hyperthermia Association of the United States has issued guidelines recommending that 36 vials (20 mg per vial) of dantrolene remain in stock at every surgery center. (sciencedaily.com)
  • The purpose of this analysis is to assess the cost-effectiveness of stocking dantrolene in ambulatory surgery centers as recommended by the Malignant Hyperthermia Association of the United States. (sciencedaily.com)
  • The results of this analysis suggest that stocking dantrolene for the treatment of MH in ambulatory surgery centers as recommended by the Malignant Hyperthermia Association of the United States is cost-effective when compared with the estimated values of statistical life used by U.S. regulatory agencies. (sciencedaily.com)
  • Clinical observations suggest that oral dantrolene may relief myopathic symptoms in MH-susceptible (MHS) patients. (bvsalud.org)
  • RESULTS: Among 476 MHS patients with positive CHCT, 193 had muscle symptoms, 164 started oral dantrolene, 27 refused treatment, and 2 were excluded due to abnormal liver function before starting therapy. (bvsalud.org)
Ryanodine receptor2
  • citation needed] In a large proportion (50-70%) of cases, the propensity for malignant hyperthermia is due to a mutation of the ryanodine receptor (type 1), located on the sarcoplasmic reticulum (SR), the organelle within skeletal muscle cells that stores calcium. (wikipedia.org)
  • The STAC3 protein interacts with two structures in muscle cells that are critical for calcium ion flow, dihydropyridine receptor (DHPR) and ryanodine receptor 1 (RYR1). (medlineplus.gov)
Fever5
  • Symptoms include muscle rigidity, fever, and a fast heart rate. (wikipedia.org)
  • Sevoflurane should not be used in patients with a history of confirmed hepatitis due to a halogenated inhalational anesthetic or a history of unexplained moderate to severe hepatic dysfunction with jaundice, fever and eosinophilia after anaesthesia with sevoflurane. (medicines.org.uk)
  • Hyperthermia, also referred to as fever (pyrexia), occurs when body heat regulation mechanisms become overwhelmed or impaired resulting in dangerously elevated body temperatures that often exceed the normal range of 98.6degF (37degC). (keydifference.info)
  • Hyperthermia differs from fever in that its causes typically lie beyond infection or inflammation and instead occur as an adverse response by overstretching these mechanisms or becoming overwhelmed altogether. (keydifference.info)
  • Take vital signs hyperthermia fever treatment malignant hyperthermia precautions temperature regulation vital signs. (reflectionsbodysolutions.com)
Halothane4
  • The most common triggering agents are volatile anesthetic gases, such as halothane, sevoflurane, desflurane, isoflurane, enflurane or the depolarizing muscle relaxants suxamethonium and decamethonium used primarily in general anesthesia. (wikipedia.org)
  • Hallmarks of halothane-hypersensitive patients include high incidence of musculoskeletal symptoms at rest and abnormal calcium events in muscle. (bvsalud.org)
  • The effects on [Ca2+]cyto of halothane concentrations between 0.5 and 3 % were measured in myotubes and compared with CHCT responses of muscle. (bvsalud.org)
  • A sample of muscle tissue is tested to see whether it contracts in response to caffeine and halothane ( caffeine halothane contracture test). (msdmanuals.com)
20221
  • Nyirenda, Luther, "Malignant Hyperthermia" (2022). (otterbein.edu)
Severe5
  • Malignant hyperthermia (MH) is a type of severe reaction that occurs in response to particular medications used during general anesthesia, among those who are susceptible. (wikipedia.org)
  • Severe muscle rigidity or spasms. (wren-clothing.com)
  • Untreated severe hyperthermia could result in life-threatening heatstroke, necessitating emergency medical assistance. (keydifference.info)
  • Short-term HRT for severe menopausal symptoms should avoid oral formulations. (asperbio.com)
  • They are in addition used as antiemetics, in the control of intractable hiccup, in severe pruritis and for induction of hypothermia in association with anesthetic drugs. (biologydiscussion.com)
Serotonin Syndrome2
  • Serotonin syndrome presents a variety of symptoms that can be difficult to diagnose. (lww.com)
  • Keep in mind that serotonin syndrome isn't a diagnosis that's restricted to the ED. The nurse should also be prepared to encounter patients with mild symptoms in the outpatient setting. (lww.com)
Skeletal10
  • Malignant hyperthermia (MH) is a rare hypermetabolic syndrome of the skeletal muscle and a potentially fatal complication of general anesthesia. (sciencedaily.com)
  • The disorder is due to abnormally increased levels of cell calcium in the skeletal muscle. (sciencedaily.com)
  • The direct cause of MH when it is triggered is uncontrolled release of intracellular calcium from the skeletal muscle sarcoplasmic reticulum. (medscape.com)
  • Malignant hyperthermia (MH) is a rare, life-threatening, and rapidly progressing disorder of the skeletal muscle tissue. (otterbein.edu)
  • Calcium ion movements between cellular stores and the cytosol govern muscle contraction, the most energy-consuming function in mammals, which confers skeletal myofibers a pivotal role in glycemia regulation. (bvsalud.org)
  • STAC3 disorder (formerly known as Native American myopathy) is a condition that primarily affects skeletal muscles, which are muscles that the body uses for movement. (medlineplus.gov)
  • This gene provides instructions for making a protein that plays a role in the tensing (contraction) of skeletal muscles. (medlineplus.gov)
  • As a result, large amounts of calcium ions are released from storage within muscle cells, causing skeletal muscles to contract abnormally. (medlineplus.gov)
  • However, CPK also may increase from handling stress and from cardiac and skeletal muscle damage (capture myopathy syndrome) not associated with a hypothermic event (Bossart and Dierauf, 1990). (wildliferesearch.com)
  • to provide skeletal muscle relaxation during surgery or mechanical ventilation. (nih.gov)
Anesthesia6
  • It can be induced with the use of neuromuscular blocking agents and inhaled anesthetics which are frequently used by anesthesia providers. (otterbein.edu)
  • Malignant hyperthermia can occur when the anesthesia is given or during or soon after surgery. (msdmanuals.com)
  • Malignant hyperthermia may develop during anesthesia or shortly after surgery. (msdmanuals.com)
  • People with a family history of the disorder or a previous serious side effect during anesthesia can be tested to see whether they are susceptible to malignant hyperthermia. (msdmanuals.com)
  • administration with a neuroleptic as an anesthetic premedication, for the induction of anesthesia and as an adjunct in the maintenance of general and regional anesthesia. (pfizermedicalinformation.com)
  • Regional anesthesia: Loss of pain sensation, with varying degrees of muscle relaxation, in certain regions of the body. (wikidoc.org)
Temperature11
  • Symptoms include body temperature of up to 107 degrees, muscle rigidity, system-wide organ failure, and possible death. (sciencedaily.com)
  • How high can the temperature get with a patient with malignant hyperthermia? (wren-clothing.com)
  • Malignant hyperthermia is when certain kinds of anesthetics (or sometimes intense exercise or high air temperature) cause hyperthermia. (wren-clothing.com)
  • Hyperthermia refers to a condition wherein one's body temperature increases beyond normal parameters (usually around 98.6degF or 37degC), usually as the result of external influences like extreme heat, physical exertion, or heatstroke. (keydifference.info)
  • Hyperthermia arises when your natural thermoregulatory mechanisms become overwhelmed or impaired and no longer allow your body to maintain an appropriate body temperature. (keydifference.info)
  • or neurological diseases underlying them all can all increase blood temperature significantly and bring on hyperthermia symptoms. (keydifference.info)
  • Preventing hyperthermia involves staying hydrated, limiting excessive heat exposure and being aware of risks in high-temperature environments during hot weather or intense physical activity. (keydifference.info)
  • If the core temperature drops below 32°C (90°F), shivering ceases, muscle tone increases, and the animal may appear in rigor mortis. (wildliferesearch.com)
  • Peripheral vasoconstriction and shivering are frequent physiological manifestations of mild hypothermia as core temperature declines to 32°C (90°F). At lower core temperatures, hyporeflexia, stupor, cessation of shivering, and muscle rigidity become evident (Knochel, 1985). (wildliferesearch.com)
  • Malignant hyperthermia is a rare, life-threatening rise in body temperature that occurs in susceptible people who are given certain muscle-relaxing drugs plus an anesthetic gas for surgery. (msdmanuals.com)
  • Muscle cells become overactive, causing sustained muscle contractions that produce heat and raise body temperature extremely high. (msdmanuals.com)
Respiratory3
  • limit dosages and durations to the minimum required and follow patients for signs and symptoms of respiratory depression and sedation ( 5.4 ). (drugs.com)
  • 64 actions/interventions monitor for signs and symptoms of respiratory infection. (reflectionsbodysolutions.com)
  • Fentanyl Citrate Injection should be administered only by persons specifically trained in the use of intravenous anesthetics and management of the respiratory effects of potent opioids. (pfizermedicalinformation.com)
Extrapyramidal Symptoms1
  • May induce disorientation, unconsciousness, and extrapyramidal symptoms. (medicscientist.com)
Patients10
  • Although anesthetic agents are the most common trigger of MH in susceptible individuals, some patients may develop MH symptoms in response to heat or stress. (medscape.com)
  • Often, MH-susceptible patients have never had MH and may even have had several exposures to MH-triggering anesthetics without developing the syndrome. (medscape.com)
  • Desflurane, USP, Liquid for Inhalation should not be used as the sole agent for anesthetic induction in patients with coronary artery disease or where increases in heart rate or blood pressure are undesirable. (nih.gov)
  • May cause sensitivity hepatitis in patients sensitized by previous exposure to halogenated anesthetics. (nih.gov)
  • Nitrous oxide is not associated with nephrotoxicity or hepatotoxicity and is safe to use in patients susceptible to malignant hyperthermia. (wren-clothing.com)
  • Chronic myoplasmic calcium elevation ("calcium stress"), found in malignant hyperthermia-susceptible (MHS) patients and multiple myopathies, has been suggested to underlie the progression from hyperglycemia to insulin resistance. (bvsalud.org)
  • We find that muscle cells derived from MHS patients have increased content of an activated fragment of GSK3ß - a specialized kinase that inhibits glycogen synthase, impairing glucose utilization and delineating a path to hyperglycemia. (bvsalud.org)
  • A clinical index that summarises patient symptoms was determined for 67 patients, together with a calcium index summarising resting [Ca2+]cyto and spontaneous and electrically evoked Ca2+ events in their primary myotubes. (bvsalud.org)
  • use as an anesthetic agent with oxygen in selected high risk patients, such as those undergoing open heart surgery or certain complicated neurological or orthopedic procedures. (pfizermedicalinformation.com)
  • Medical Assessment of the Patient With Mental Symptoms Patients with mental complaints or concerns or disordered behavior present in a variety of clinical settings, including primary care and emergency treatment centers. (merckmanuals.com)
Relaxant1
  • Malignant hyperthermia occurs in response to some anesthetic drugs, which are used to block the sensation of pain, either given alone or in combination with a particular type of muscle relaxant. (medlineplus.gov)
RYR13
  • RYR1 opens in response to conformational changes in the L-type calcium channels following membrane depolarisation, thereby resulting in a drastic increase in intracellular calcium levels and muscle contraction. (wikipedia.org)
  • In response to certain signals, DHPR turns on (activates) the RYR1 channel, and the activated RYR1 channel releases calcium ions stored in structures inside muscle cells. (medlineplus.gov)
  • Mutations in other genes related to malignant hyperthermia activate the RYR1 channel improperly in response to certain drugs. (medlineplus.gov)
Seizures1
  • Withdrawal symptoms, including jitteriness, tremor, and seizures, have been reported in neonates whose mothers had taken clomipramine hydrochloride capsules until delivery. (drugcentral.org)
Weakness5
  • People with STAC3 disorder have muscle weakness (myopathy) and poor muscle tone (hypotonia) throughout the body that typically begins at birth. (medlineplus.gov)
  • Muscle weakness underlies many of the characteristic features of STAC3 disorder. (medlineplus.gov)
  • A disruption in calcium ion release prevents muscles from contracting normally, leading to the muscle weakness characteristic of STAC3 disorder. (medlineplus.gov)
  • Symptoms may include: headache weakness or feeling unsteady confusion, problems concentrating or thinking or memory problemsVisual problemseye pain changes in vision swelling or redness in or around the eyeOnly some people are at risk for these problems. (drugcentral.org)
  • Ataxia - A problem of muscle coordination not due to apraxia, weakness, rigidity, spasticity or sensory loss. (silverneurosurgery.com)
Complications2
Susceptible individuals2
Occur2
Dissociative3
  • Also known as Vitamin K, Special K, and K, Ketamine is a dissociative anesthetic medication. (usnodrugs.com)
  • Due to the sedating effects that it provides, Ketamine is commonly referred to as a dissociative anesthetic drug. (usnodrugs.com)
  • Ketamine and Phencyclidine (PCP) Ketamine and phencyclidine are N-methyl-D-aspartate receptor antagonists and dissociative anesthetics that can cause intoxication, sometimes with confusion or a catatonic state. (merckmanuals.com)
Pyrexia1
  • Distinguishing between hyperthermia and pyrexia in clinical settings is of vital importance, as accurate diagnosis ensures appropriate treatments such as cooling measures to address external factors in cases of hyperthermia or targeted therapy including antipyretic medication in cases of pyrexia. (keydifference.info)
Hypothermia1
  • Disruption of the body's ability to thermoregulate can lead to temperatures that are too low (hypothermia) or too high (hyperthermia). (nih.gov)
Restlessness1
  • Various disorders of movement are common due to dopamine blocking action, which includes Parkinson-like syndrome, akathisia (feeling of restlessness and inability to stand still), dystonia (uncontrolled movements especially of facial muscles and torticollis) and tardive dyskinesia (abnormal movements of the mouth and tongue and sometimes the upper limbs). (biologydiscussion.com)
Treatment3
  • Once inside hyperthermia's grasp, its ability to regulate itself becomes overwhelming leading to symptoms like flushed skin, rapid heart rate, and heavy sweating treatment usually includes taking cooling measures and eliminating potential sources such as moving away from hot environments or taking steps like leaving outing yourself from hot environments altogether. (keydifference.info)
  • In the presence of signs of malignant hyperthermia, appropriate treatment should be instituted concurrently. (nih.gov)
  • 3 They need to be reassured that their symptoms are real, and that treatment is available for this complex set of disorders. (vulvovaginaldisorders.org)
Mutations1
Rapid3
  • If your body's ability to dissipate heat is compromised it could lead to symptoms including flushed skin, rapid heart rate, excess sweating confusion as well as organ damage or failure if left untreated. (keydifference.info)
  • Some common heat-related symptoms include flushed or hot skin, rapid heart rate, heavy sweating and confusion - in extreme cases this could even result in unconsciousness or organ damage. (keydifference.info)
  • Often, the first signs are rapid breathing, a fast heart rate, and muscle rigidity, especially in the jaw. (msdmanuals.com)
Fibers1
  • The resulting increase in calcium concentrations within the cells cause the muscle fibers to contract. (wikipedia.org)
Diarrhea1
Diagnosis3
  • Diagnosis is based on symptoms in the appropriate situation. (wikipedia.org)
  • In addition to the conditions listed in the differential diagnosis, there are a number of other conditions and circumstances that may mimic malignant hyperthermia (MH), including the following: Contrast dye. (wren-clothing.com)
  • Diagnosis should include a detailed history, physical examination, and routine laboratory tests, in addition to symptom-directed workup with cultures. (lecturio.com)
Injection1
  • While traditionally administered as a single injection, newer techniques involve placement of indwelling catheters for continuous or intermittent administration of local anesthetics. (wikidoc.org)
Nitrous oxide1
Analgesic2
  • It possesses an analgesic property that all modern anesthetics lack and is short acting, with quick onset and offset of action. (wren-clothing.com)
  • analgesic action of short duration during the anesthetic periods, premedication, induction and maintenance, and in the immediate postoperative period (recovery room) as the need arises. (pfizermedicalinformation.com)
Genetic1
  • Family members may be tested to see if they are susceptible by muscle biopsy or genetic testing. (wikipedia.org)
Calcium ions within muscle cells1
Breakdown1
Degrees1
Phenothiazines1
  • Phenothiazines relieve florid psychotic symptoms such as thought disorders, hallucinations and delusions. (biologydiscussion.com)
Disorder1
  • Malignant hyperthermia is a disorder that can be considered a gene-environment interaction. (wikipedia.org)
Fluids1
  • Manage hyperthermia using immediate cooling measures that lower body temperatures as soon as they appear and target its root causes, including relocation to cooler surroundings, adequate hydration or medical interventions like intravenous fluids or cooling blankets. (keydifference.info)
Include1
  • Multiple dilations are often the only symptom of nicotine include lobeline, derived from the environment that increase anxiety and provides realistic role expectations. (reflectionsbodysolutions.com)
Gases2
Tardive dyskinesia1
  • May worsen schizophrenic symptoms, decrease haloperidol serum concentrations, and lead to tardive dyskinesia. (medicscientist.com)