Question 68

Serotonin syndrome may result from a drug-drug interaction between mirtazapine and buspirone.

Mirtazapine and buspirone can interact in a way that increases serotonin levels in the brain, which may lead to serotonin syndrome, a potentially life-threatening condition.

A) Mirtazapine and buspirone

This option is correct as both mirtazapine, an antidepressant, and buspirone, an anxiolytic, can elevate serotonin levels. The combination of these drugs can lead to an excessive accumulation of serotonin, increasing the risk of serotonin syndrome.

B) Montelukast and brimonidine

Montelukast is primarily used as a leukotriene receptor antagonist for asthma and allergies, while brimonidine is an alpha-2 adrenergic agonist used for glaucoma. There is no significant pharmacological interaction between these two medications that would lead to serotonin syndrome.

C) Mupirocin and betamethasone

Mupirocin is an antibiotic used for skin infections, and betamethasone is a corticosteroid. These medications do not interact in a way that affects serotonin levels, and therefore do not pose a risk for serotonin syndrome.

D) Meloxicam and bisoprolol

Meloxicam is a nonsteroidal anti-inflammatory drug (NSAID), and bisoprolol is a beta-blocker used for hypertension. These drugs do not interact with serotonin pathways, making the risk of serotonin syndrome negligible.

Conclusion

Mirtazapine and buspirone are the only combination listed that poses a risk of serotonin syndrome due to their effects on serotonin levels in the brain. In contrast, the other options do not have significant interactions that would lead to this condition, confirming that A is the only correct choice.