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Cardiac arrest secondary to propafenone overdose

Year 2014, Volume: 41 Issue: 3, - , 01.09.2014
https://doi.org/10.5798/diclemedj.0921.2014.03.0486

Abstract

Propafenone is a group 1C antiarrhythmic agent. Serious side effects such as cardiac arrest may occur when excessive intake. A sixteen year-old female was admitted to emergency department with nausea, vomiting, and altered mental status. Wide QRS tachycardia and subsequent ventricular fibrillation occurred following gastric lavage in the patient who confesses that she had taken excessive amount (4500mg propafenone) of drug for the purpose of suicide. After cardiopulmonary resuscitation for ten minutes the patient was intubated because of blurred consciousness and shallow breathing. Transtoracic echocardiography didn\'t show any pathology. First degree AV block and widened QRS complexes determined in her electrocardiograph (ECG) after resuscitation. These pathological changes in the ECG and clinical status of the patient improved completely in the following days and she was discharged from hospital without any sequelae.

References

  • Sönmez E, Karakuş A, Çavuş UY, et al. Evaluation of in- toxication cases admitted to Emergency Department of a University Hospital. Dicle Med J. 2012;39: 21-26.
  • Capucci A, Boriani G. Propafenone in the treatment of cardiac arrhythmias. A risk-benefit appraisal. Drug Saf 1995;12:55-72.
  • John MM, Douglas PZ. Therapy for Cardiac Arrhythmias. Braunwald’s Heart Disease. 7th ed. Philadelphia. 2005 p 713-757
  • Kerns W 2nd, English B, Ford M. Propafenone overdose. Ann Emerg Med 1994;24:98-103.
  • Koppel C, Oberdisse U, Heinemeyer G. Clinical course and outcome in class IC antiarrythmic overdose. J Toxicol Clin Toxicol 1990;28:433-444.
  • Lovecchio F, Berlin R, Brubacher JR, et al. Hypertonic so- dium bicarbonate in an acute flecainide overdose. Am J Emerg Med 1998;16:534-537.
  • Burgess ED, Duff HJ. Hemodialysis removal of propafe- none. Pharmacotherapy 1989;9:331-333.
  • Yi HY, Lee JY, Lee SY, et al. Cardioprotective effect of glucose-insulin on acute propafenone toxicity in rat. Am J Emerg Med 2012;30:680-689.

Propafenon aşırı dozuna bağlı gelişen kardiyak arrest

Year 2014, Volume: 41 Issue: 3, - , 01.09.2014
https://doi.org/10.5798/diclemedj.0921.2014.03.0486

Abstract

Propafenon sınıf 1C antiaaritmik bir ilaçtır. Fazla alınması durumunda, kardiyak arrest gibi ciddi yan etkiler gözlenebilir. On altı yaşında bir bayan acil servise bulantı, kusma ve bilinç değişikliği ile getirildi. İntihar amaçlı ilaç aldığını (4500 mg propafenon) ifade eden hastaya mide lavajı yapıldı ve hasta monitorize edildi. Ritm takiplerinde önce geniş QRS\'li taşikardi ve sonrasında ventriküler fibrilasyon gelişti. Hastaya yaklaşık 10 dk resüsitasyon yapıldı. Bilinci tam açık olmadığı için ve solunumun yüzeysel olduğu için hasta entübe edildi. Ekokardiyografik tetkikinde patoloji saptanmadı. Elektrokardiyografide (EKG) QRS süresinde genişleme, 1. derecede AV blok saptandı. EKG\'deki bu patolojik değişiklikler ve hastanın klinik durumu takip eden günlerde tamamen düzeldi ve hasta sekelsiz olarak taburcu edildi.

References

  • Sönmez E, Karakuş A, Çavuş UY, et al. Evaluation of in- toxication cases admitted to Emergency Department of a University Hospital. Dicle Med J. 2012;39: 21-26.
  • Capucci A, Boriani G. Propafenone in the treatment of cardiac arrhythmias. A risk-benefit appraisal. Drug Saf 1995;12:55-72.
  • John MM, Douglas PZ. Therapy for Cardiac Arrhythmias. Braunwald’s Heart Disease. 7th ed. Philadelphia. 2005 p 713-757
  • Kerns W 2nd, English B, Ford M. Propafenone overdose. Ann Emerg Med 1994;24:98-103.
  • Koppel C, Oberdisse U, Heinemeyer G. Clinical course and outcome in class IC antiarrythmic overdose. J Toxicol Clin Toxicol 1990;28:433-444.
  • Lovecchio F, Berlin R, Brubacher JR, et al. Hypertonic so- dium bicarbonate in an acute flecainide overdose. Am J Emerg Med 1998;16:534-537.
  • Burgess ED, Duff HJ. Hemodialysis removal of propafe- none. Pharmacotherapy 1989;9:331-333.
  • Yi HY, Lee JY, Lee SY, et al. Cardioprotective effect of glucose-insulin on acute propafenone toxicity in rat. Am J Emerg Med 2012;30:680-689.
There are 8 citations in total.

Details

Primary Language Turkish
Journal Section Case Reports
Authors

Nihat Polat This is me

Murat Yüksel This is me

Mesut Aydın This is me

Fethullah Kayan This is me

Sait Alan This is me

Publication Date September 1, 2014
Submission Date March 1, 2015
Published in Issue Year 2014 Volume: 41 Issue: 3

Cite

APA Polat, N., Yüksel, M., Aydın, M., Kayan, F., et al. (2014). Propafenon aşırı dozuna bağlı gelişen kardiyak arrest. Dicle Medical Journal, 41(3). https://doi.org/10.5798/diclemedj.0921.2014.03.0486
AMA Polat N, Yüksel M, Aydın M, Kayan F, Alan S. Propafenon aşırı dozuna bağlı gelişen kardiyak arrest. diclemedj. September 2014;41(3). doi:10.5798/diclemedj.0921.2014.03.0486
Chicago Polat, Nihat, Murat Yüksel, Mesut Aydın, Fethullah Kayan, and Sait Alan. “Propafenon aşırı Dozuna bağlı gelişen Kardiyak Arrest”. Dicle Medical Journal 41, no. 3 (September 2014). https://doi.org/10.5798/diclemedj.0921.2014.03.0486.
EndNote Polat N, Yüksel M, Aydın M, Kayan F, Alan S (September 1, 2014) Propafenon aşırı dozuna bağlı gelişen kardiyak arrest. Dicle Medical Journal 41 3
IEEE N. Polat, M. Yüksel, M. Aydın, F. Kayan, and S. Alan, “Propafenon aşırı dozuna bağlı gelişen kardiyak arrest”, diclemedj, vol. 41, no. 3, 2014, doi: 10.5798/diclemedj.0921.2014.03.0486.
ISNAD Polat, Nihat et al. “Propafenon aşırı Dozuna bağlı gelişen Kardiyak Arrest”. Dicle Medical Journal 41/3 (September 2014). https://doi.org/10.5798/diclemedj.0921.2014.03.0486.
JAMA Polat N, Yüksel M, Aydın M, Kayan F, Alan S. Propafenon aşırı dozuna bağlı gelişen kardiyak arrest. diclemedj. 2014;41. doi:10.5798/diclemedj.0921.2014.03.0486.
MLA Polat, Nihat et al. “Propafenon aşırı Dozuna bağlı gelişen Kardiyak Arrest”. Dicle Medical Journal, vol. 41, no. 3, 2014, doi:10.5798/diclemedj.0921.2014.03.0486.
Vancouver Polat N, Yüksel M, Aydın M, Kayan F, Alan S. Propafenon aşırı dozuna bağlı gelişen kardiyak arrest. diclemedj. 2014;41(3).