An adrenergic storm is a sudden and dramatic increase in serum levels of the catecholamines adrenaline and noradrenaline (also known as epinephrine and norepinephrine respectively), with a less significant increase in dopamine transmission. It is a life-threatening condition because of extreme tachycardia and hypertension, and is especially dire for those with prior heart problems. If treatment is prompt, prognosis is good; typically large amounts of diazepam or other benzodiazepines are administered alongside beta blockers. Beta blockers are contraindicated in some patients, so other anti-hypertensive medication such as clonidine may be used.[1]
Antipsychotics are also used to treat the most severe psychiatric reactions such as psychosis, paranoia or terror, after their use was formerly discouraged because of their potential to prolong the QT interval; however, more recent research performed since 2019 has revealed that this and other severe side effects are rare and their occurrence does not warrant banning antipsychotics from the treatment of adrenergic crises for which they can be extremely useful.[2][3][4][5][6][7][8]
Adreneric storms are usually caused by overdoses of stimulants, especially cocaine or methamphetamine, or eating foods high in tyramine while taking monoamine oxidase inhibitors.[9] A subarachnoid hemorrhage can also cause an adrenergic storm.[9] A catecholamine storm is part of the normal course of rabies infection, and is responsible for the severe feelings of agitation, terror, and dysautonomia present in the pre-coma stage of the disease.[10]
^King, Andrew; Dimovska, Mirjana; Bisoski, Luke (24 February 2018). Oparil, Suzanne (ed.). "Sympathomimetic toxidromes and other pharmacological causes of acute hypertension". Current Hypertension Reports. 20 (1). Basingstoke, United Kingdom: Springer Nature: 8. doi:10.1007/s11906-018-0807-9. ISSN 1522-6417. OCLC 46464855. PMID 29478133. S2CID 3530495.
^Cite error: The named reference Malashock was invoked but never defined (see the help page).
^Cite error: The named reference Connors was invoked but never defined (see the help page).
^Richards, John R.; Derlet, Robert W. (10 December 2019). White, J. Douglas; Brady, William J. (eds.). "Another dogma dispelled? Antipsychotic treatment of sympathomimetic toxicity". The American Journal of Emergency Medicine. 37 (12). Amsterdam, Netherlands: Elsevier: 2256–2257. doi:10.1016/j.ajem.2019.05.013. ISSN 0735-6757. OCLC 08996781. PMID 31088749. S2CID 155090660. Retrieved 28 July 2021 – via ScienceDirect.
^Goldstein, Scott; Richards, John R. (1 January 2020). Richards, John R. (ed.). Sympathomimetic Toxicity. Treasure Island, Florida, United States of America: StatPearls Publishing. PMID 28613508. Retrieved 28 July 2021 – via NCBI (National Center for Biotechnology Information)/NLM (United States National Library of Medicine).
^Connors, Nicholas J.; Alsakha, Ahmed; Larocque, Alexandre; Hoffman, Robert S.; Landry, Tara; Gosselin, Sophie (1 December 2019). White, J. Douglas; Brady, William J. (eds.). "Evidence over dogma and anecdotes". The American Journal of Emergency Medicine. 37 (12). Amsterdam, Netherlands: Elsevier: 2257. doi:10.1016/j.ajem.2019.05.014. ISSN 0735-6757. OCLC 08996781. PMID 31128936. S2CID 167206288. Retrieved 28 July 2021.
^Lam, Vivian; Shaffer, Robert W. (2017). "8. Management of Sympathomimetic Overdose Including Designer Drugs". In Hyzy, Robert C.; McSparron, Jakob (eds.). Evidence-Based Critical Care: A Case Study Approach (2nd ed.). Cham, Switzerland: Springer Nature. p. 65. doi:10.1007/978-3-030-26710-0. ISBN 978-3030267094. S2CID 202810365 – via Google Books.
^Roberts, James R. (1 January 2016). Roberts, James R.; Hoffman, Lisa; Nace, Lynn; Gibson, Grace (eds.). "InFocus: Treating Sympathomimetic Toxicity". Emergency Medicine News. 38 (1). Wolters Kluwer Health, Inc. (Lippincott Williams & Wilkins): 10–12. doi:10.1097/01.EEM.0000476273.56614.28. Archived from the original on 10 January 2016. Retrieved 28 July 2021.
^ abCite error: The named reference :0 was invoked but never defined (see the help page).
^Holstege, Christopher P.; Borek, Heather A. (29 August 2012). Kellum, John A. (ed.). "Toxidromes". Critical Care Clinics. 28 (4). Amsterdam, Netherlands: Elsevier: 479–498. doi:10.1016/j.ccc.2012.07.008. ISSN 0749-0704. LCCN 85643425. OCLC 11078407. PMID 22998986. Retrieved 28 July 2021.
An adrenergicstorm is a sudden and dramatic increase in serum levels of the catecholamines adrenaline and noradrenaline (also known as epinephrine and...
of the catecholamines Sympathomimetic drugs (also known as adrenergic drugs and adrenergic amines) are stimulant compounds which mimic the effects of...
Fischer N, et al. (July 2020). "Preventing cytokine storm syndrome in COVID-19 using α-1 adrenergic receptor antagonists". The Journal of Clinical Investigation...
pass urine. An extremely large overdose may produce symptoms such as adrenergicstorm, methamphetamine psychosis, substantially reduced or no urine output...
lethal serotonin syndrome. Combination with MAOIs may also result in an adrenergicstorm. Use of tapentadol with alcohol or other sedatives such as benzodiazepines...
despite its proclivity to release DAT can lead to a life-threatening adrenergicstorm. Methedrone's high selectivity for SERT places it among the highest...
blocker, or an antagonist of the β-adrenergic receptors. It is specifically a selective antagonist of the β1-adrenergic receptor and has no intrinsic sympathomimetic...
palpitations, trembling, and anxiety are mediated by increases in beta-adrenergic receptors on cell surfaces. Beta blockers, typically used to treat high...
β1 and β2 adrenoreceptor agonist and has almost no activity on alpha adrenergic receptors at low levels. However, at higher concentrations, isoprenaline...
depends on the overall function of three autonomic functions—cardiovagal, adrenergic, and sudomotor. A diagnosis should at a minimum include measurements of...
additionally acts as a potent inhibitor of the serotonin 5-HT2A, 5-HT2C, the α1A-adrenergic, the histamine H1 and the M1-M5 muscarinic acetylcholine receptors (see...
Landiolol (INN) is an ultra short-acting, β1-superselective intravenous adrenergic antagonist, which decreases the heart rate effectively with less negative...
as obesity. Medications used include stimulants, atomoxetine, alpha-2 adrenergic receptor agonists, and sometimes antidepressants. In those who have trouble...
of the bed be raised if possible to improve ventilation. However, β2 adrenergic receptor agonists are not recommended to treat ARDS because it may reduce...
catecholamines. Epinephrine is also believed to stimulate receptors through the β-adrenergic pathway to decrease eosinophils in peripheral blood. Use of glucocorticoids...
Hollingshead, reputed for introducing LSD to various artists and musicians like Storm Thorgerson, Donovan, Keith Richards, and members of the Beatles, played...
methylphenidate is extremely rare, but limited evidence suggests that intake of β-adrenergic agonists with methylphenidate may increase the risk of liver toxicity...
(EADs), and they are increased in states of adrenergic stimulation, steps can be taken to blunt adrenergic stimulation in these individuals. These include...
adipocyte function, and not through direct Beta-2 adrenergic receptor activation, suggesting that adrenergic stimulation of macrophages may be insufficient...
inhibitor), propranolol, a nonselective beta blocker, clonidine, an alpha 2 adrenergic agonist or CP-154,526, a corticotropin-releasing hormone antagonist. Faulty...
Blackwell Pub. p. 165. ISBN 9781444312836. Rau JL (Jul 2000). "Inhaled adrenergic bronchodilators: historical development and clinical application". Respir...
Suits On Its Antidepressant Drug Prozac". The New York Times. "Eli Lilly in storm over Prozac evidence". Financial Times. 30 December 2004. Retrieved 20 March...
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