Red man syndrome is a side effect of?

VSSC Nursing Officer - 2021

Pharmacology

Easy

Appeared in: VSSC Nursing Officer - 2021

Explanation

Red man syndrome (RMS) is a well-documented infusion-related reaction primarily associated with the antibiotic vancomycin.
It is not a true IgE-mediated allergy but a pseudoallergic reaction caused by the rapid infusion of the drug.
The rapid infusion triggers mast cells and basophils to release large amounts of histamine, leading to the characteristic symptoms.
Symptoms include flushing, itching, and an erythematous rash on the face, neck, and upper torso.
Management involves stopping the infusion, administering antihistamines, and then restarting at a slower rate once symptoms subside.

Option A: Streptomycin is an aminoglycoside antibiotic. Its primary and most serious adverse effects are ototoxicity (damage to the ear, affecting hearing and balance) and nephrotoxicity (kidney damage).
Option C: Tetracycline is known for causing different side effects, such as photosensitivity (making the skin highly sensitive to sunlight), discoloration of developing teeth (hence it's avoided in children under 8 and pregnant women), and gastrointestinal disturbances.
Option D: Chloramphenicol is a potent broad-spectrum antibiotic reserved for serious infections due to its severe side effects. Its most notable toxicities are dose-related bone marrow suppression and idiosyncratic aplastic anemia, which is rare but often fatal. It also causes 'gray baby syndrome' in neonates.

Clinical Relevance

Nursing practice connection: Use the key finding related to Pharmacology: Antibiotic Side Effects to guide bedside assessment, documentation, and the next nursing action.
Nurses are directly responsible for administering IV vancomycin and must know the correct infusion rate to prevent Red Man Syndrome. A standard 1-gram dose should be infused over at least 60 minutes.
It is a critical nursing responsibility to monitor patients during vancomycin infusion for signs of RMS. Early detection allows for prompt intervention, preventing more severe reactions like hypotension.
Patient education is key. The nurse should explain the potential for this reaction and instruct the patient to report any itching, flushing, or feeling of warmth immediately.

How to Approach the Question

First, identify the key term in the question: 'Red man syndrome'.
This is a factual recall question that tests your knowledge of specific, unique side effects of common medications.
Systematically review the options, which are all antibiotics. Try to recall the most famous or dangerous side effect associated with each one.
Recall or deduce that Streptomycin is linked to ototoxicity, Tetracycline to teeth staining, and Chloramphenicol to aplastic anemia.
The term 'Red man syndrome' is uniquely and strongly associated with Vancomycin. This direct link makes it the most plausible answer.
Confirm the choice by remembering that this syndrome is caused by rapid infusion, a key detail in vancomycin administration protocols.

Concept Tested & Keywords

Concept Tested: Pharmacology: Antibiotic Side Effects
Stem keywords: Red man syndrome, side effect
Lead-in keywords: is
Clinical cues: The image showing flushing and erythema of the upper body is a classic visual cue for Red Man Syndrome.
Negative lead-in flag: false

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E6 Pharmacology Nursing Lilley 11e Part 2 p. 324-325

E6 Pharmacology Nursing Lilley 11e Part 3 p. 1