PTCB Certified Pharmacy Technician (PTCE)MedicationsHard
A pharmacy technician is receiving a prescription for 'linezolid 600 mg, take 1 tablet twice daily'. The patient's profile shows they are also taking sertraline. What severe potential drug interaction should the technician be aware of?
- ADecreased effectiveness of linezolid
- BIncreased risk of nephrotoxicity
- CIncreased risk of hyperkalemia
- DIncreased risk of serotonin syndrome
Show answer & explanationAnswer & explanation
Correct answer: D. Increased risk of serotonin syndrome
Linezolid is a weak monoamine oxidase inhibitor (MAOI) and can interact with serotonergic drugs like sertraline (an SSRI). This combination can lead to a dangerous buildup of serotonin in the brain, resulting in serotonin syndrome. This is a critical drug interaction requiring pharmacist intervention.
Why the other options are wrong
- A. Linezolid effectiveness is not typically decreased by sertraline; the interaction is additive serotonin.
- B. Nephrotoxicity is not a primary concern with this specific drug interaction.
- C. Hyperkalemia is not a known interaction between linezolid and sertraline.
Linezolid-SSRI Interaction (Serotonin Syndrome)
Linezolid possesses weak monoamine oxidase inhibitor (MAOI) properties. When co-administered with serotonergic agents like SSRIs (e.g., sertraline), it can dangerously increase serotonin levels in the central nervous system, leading to serotonin syndrome.
- Serotonin syndrome symptoms: agitation, confusion, rapid heart rate, muscle rigidity, sweating.
- MAOIs prevent serotonin breakdown, SSRIs increase serotonin release/reuptake inhibition.
- This interaction is potentially life-threatening and requires immediate attention.
Memory trick: Serotonin syndrome is like a 'short circuit' in the brain.