A48-year-old woman was admitted to the emergency department because of fever (103.1°F, 39.5°C), flushing, sweating, tremors, and altered consciousness. Medical history indicated that she had been suffering from depression for 8 years, currently treated with paroxetine, and for insomnia, currently treated with zolpidem. The patient also reported that 24 hours earlier, she had self-administered three tablets of a drug given to her by a friend to treat a severe headache. Further exams confirmed the preliminary diagnosis, and an appropriate treatment was started. Which of the following drugs most likely triggered the patient's disorder?

Correct Answer: B

Rationale: Step 1: Recognize the symptoms described in the scenario: fever, flushing, sweating, tremors, altered consciousness. These symptoms are indicative of serotonin syndrome. Step 2: Identify the patient's medications that can contribute to serotonin syndrome: paroxetine (an SSRI) and zolpidem (a CNS depressant). Step 3: Eliminate paroxetine as the trigger as the patient has been on it for a long time without issues. Step 4: Sumatriptan, a serotonin receptor agonist used for migraines, is the likely culprit. It can interact with SSRIs like paroxetine, leading to serotonin syndrome. Step 5: Summary: Acetaminophen (A) and ibuprofen (C) are unlikely to cause serotonin syndrome. Zolpidem (D) is less likely than sumatriptan to trigger serotonin syndrome in this case. Thus, the correct answer is B.

Correct Answer: B

Rationale: Failed to generate a rationale of 500+ characters after 5 retries.

Correct Answer: A

Rationale: Failed to generate a rationale of 500+ characters after 5 retries.

Correct Answer: C

Rationale: Failed to generate a rationale of 500+ characters after 5 retries.

Correct Answer: C

Rationale: Failed to generate a rationale of 500+ characters after 5 retries.