Harrison’s Principles of Internal Medicine Twentieth Edition UPDATES PDF Download
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Harrison’s Principles of Internal Medicine Twentieth Edition
Hyperthermia is characterised by an unchanged setting defying one week of evaluation. (Petersdorf and Beeson).
of the thermoregulatory centre with an uncontrolled It may be classified as given below. increase in body temperature that exceeds body’s ability a. Low grade PUO
to lose heat.
1. Heat stroke
2. Malignant hyperthermia is an inherent abnormality of skeletal muscle cell sarcoplasmic eticulum which is unable to store calcium ion. There is an increase in the intracellular myoplasmic calcium, leading to activation of myosin ATPase, which converts ATP to ADP + PO4 + heat thereby producing hyperthermia.
Hyperthermia is triggered by use of inhalation anaesthetics (Halothane, Cyclopropane) and muscle relaxants (Succinylcholine).
3. Neuroleptic malignant syndrome is characterised by
a. Muscular rigidity
b. Autonomic dysregulation
Neuroleptic drugs like haloperidol, phenothiazines trigger the onset of symptoms.
Treatment of the above mentioned hyperthermias is by withdrawal of the offending agents. Anti-pyretics are of no use as the thermostat is not reset to higher level.Physical cooling helps.
Central muscle relaxant (Dantrolene sodium) is helpful in the last two conditions. Bromocriptine is helpful in treatment of
neuroleptic malignant syndrome.