PAEA Surgery End Of Rotation (EOR) Practice Exam

What is typically the primary cause of red man syndrome in patients receiving vancomycin?

1. Allergic reaction to the drug

2. Rapid intravenous infusion

3. Pre-existing conditions

4. Interaction with other medications

The correct answer is: Rapid intravenous infusion

Red man syndrome is primarily associated with the rapid intravenous infusion of vancomycin. This condition is characterized by flushing, rash, and pruritus, particularly affecting the upper body. The symptoms arise when vancomycin is infused too quickly, leading to the release of histamine from mast cells. This is not an allergic reaction in the classic sense, but rather a direct effect of the drug's pharmacological actions under rapid infusion conditions. The syndrome occurs even in patients who have previously tolerated vancomycin without issues, which further supports the conclusion that the rate of administration is the key factor. Slowing down the infusion rate of vancomycin is the standard management strategy to prevent this syndrome from occurring. Additionally, pre-existing conditions and interactions with other medications may influence severity or response but are not the primary cause of red man syndrome itself.