APPLIED PHARMACOLOGYPathophysiology and Treatment of Malignant HyperthermiaGregory, Haili PharmD, BCPS; Weant, Kyle A. PharmD, BCPS, BCCCP, FCCPEditor(s): Weant, Kyle A. PharmD, BCPS, BCCCP, FCCP, Column Editor Author Information Department of Pharmacy, University of Florida Health Shands Hospital, Gainesville, Florida (Dr Gregory) and Department of Clinical Pharmacy and Outcomes Sciences, University of South Carolina College of Pharmacy, Columbia, South Carolina (Dr Weant). Corresponding Author: Kyle A. Weant, PharmD, BCPS, BCCCP, FCCP, Department of Clinical Pharmacy and Outcomes Sciences, University of South Carolina College of Pharmacy, 715 Sumter Street, Suite 109, Columbia, SC 29208 ([email protected]). Disclosure: The authors report no conflicts of interests. Advanced Emergency Nursing Journal: April/June 2021 - Volume 43 - Issue 2 - p 102-110 doi: 10.1097/TME.0000000000000344 Buy CE Test Metrics Abstract Malignant hyperthermia (MH) is caused by a genetic disorder of the skeletal muscle that induces a hypermetabolic response when patients are exposed to a triggering agent such as volatile inhaled anesthetics or depolarizing neuromuscular blockers. Symptoms of MH include increased carbon dioxide production, hyperthermia, muscle rigidity, tachypnea, tachycardia, acidosis, hyperkalemia, and rhabdomyolysis. Common scenarios for triggering agents are those used are during surgery and rapid sequence intubation. Hypermetabolic symptoms have a rapid onset; hence, prompt recognition and treatment are vital to prevent morbidity and mortality. The first-line treatment agent for an MH response is dantrolene. Further treatment includes managing complications related to a hypermetabolic response such as hyperkalemia and arrhythmias. This review is focused on the recognition and treatment considerations of MH in the emergency department to optimize therapy and improve patient morbidity and mortality. © 2021 Wolters Kluwer Health, Inc. All rights reserved.