What are some examples of SNRI?
Venlafaxine
Desvenlafaxine
What is the toxic risk dose for venlafaxine?
> 8 grams
What are the toxidromes associated with SNRI toxicity?
Serotonin toxicity
- Fever, Mental state changes, Autonomic instability, Neuromuscular abnormalities
Noradrenergic toxicity
- Acute catecholamine induced cardiomyopathy
- Progressive tachycardia
- Ventricular dysrhythmias
- Cardiogenic shock
- Death
How do you manage noradrenergic toxicity?
Assessment with echocardiogram to determine
- High dose insulin therapy
- ECMO