A Junctional Rhythm Caused by Administration of Intravenous Phenytoin

Cilt: 9 Sayı: 1 1 Ocak 2018
  • Güllü Akbaydoğan Dündar
  • İbrahim Toker
  • Hüseyin Narcı
  • Cüneyt Ayrık
Acil Tıp Olgu Sunumları Dergisi Kapak
Acil Tıp Olgu Sunumları Dergisi
PDF İndir
EN

A Junctional Rhythm Caused by Administration of Intravenous Phenytoin

Öz

Introduction: We present the case of a patient with symptomatic junctional rhythm caused by administration of intravenous phenytoin. However, bradycardia and hypotension are more commonly associated with rapid infusion of intravenous phenytoin. In our patient, the rate of intravenous phenytoin administration was <50 mg/min.Case Report: A 79-year-old woman presented to the emergency department with altered mental status for 2 h and focal seizure. After phenytoin was intravenously infused over 45 min, junctional rhythm, unresponsiveness, and hypotension developed. Atropine, dopamine, and transcutaneous pacing were initiated. After the intervention, a normal sinus rhythm with a normal heart rate was maintained. The patient was admitted to the neurological intensive care unit. Conclusion: Emergency physicians should monitor patients for possible arrhythmic effects of intravenous phenytoin therapy. In addition to geriatric patients and patients with a history of cardiac disease, there may be an increased risk of cardiotoxicity for phenytoin even at the recommended dose and infusion rate in patients with end-stage renal disease

Anahtar Kelimeler

Kaynakça

  1. Earnest MP, Marx JA, Drury LR. Complications of intravenous phenytoin for acute treatment of seizures. Recommendations for usage. Jama 1983; 249: 762-5. [CrossRef]
  2. Phenytoin poisoning [Internet]. Uptodate Wolters Kluwer. 2016 [cited 30.01.2017]. Available from: https://www.uptodate.com/contents/ phenytoin-poisoning?source=search_result&search=phenytoin%20 toxicity&selectedTitle=1~35.
  3. Hung OL, Shih RD. Antiepileptic drugs: the old and the new. Emerg Med Clin North Am 2011; 29: 141-50. [CrossRef]
  4. Khoujah D, Abraham MK. Status Epilepticus: What's New? Emerg Med Clin North Am 2016; 34: 759-76. [CrossRef]
  5. Richens A. Clinical pharmacokinetics of phenytoin. Clin Pharmacokinet 1979; 4: 153-69. [CrossRef]
  6. Cheng W, Kiang TK, Bring P, Ensom MH. Predictive Performance of the Winter-Tozer and Derivative Equations for Estimating Free Phenytoin Concentration. Can J Hosp Pharm 2016; 69: 269-79. [CrossRef]
  7. Pillai U, Hothi JC, Bhat ZY. Severe propylene glycol toxicity secondary to use of anti-epileptics. Am J Ther 2014; 21: e106-9. [CrossRef]

Ayrıntılar

Birincil Dil

İngilizce

Konular

-

Bölüm

-

Yazarlar

Güllü Akbaydoğan Dündar Bu kişi benim

İbrahim Toker Bu kişi benim

Hüseyin Narcı Bu kişi benim

Cüneyt Ayrık Bu kişi benim

Yayımlanma Tarihi

1 Ocak 2018

Gönderilme Tarihi

1 Ocak 2018

Kabul Tarihi

-

Yayımlandığı Sayı

Yıl 2018 Cilt: 9 Sayı: 1

IZ

https://izlik.org/JA28UU42SE

Kaynak Göster

RIS / Bibtex
APA
Dündar, G. A., Toker, İ., Narcı, H., & Ayrık, C. (2018). A Junctional Rhythm Caused by Administration of Intravenous Phenytoin. Journal of Emergency Medicine Case Reports, 9(1), 10-12. https://izlik.org/JA28UU42SE
AMA
1.Dündar GA, Toker İ, Narcı H, Ayrık C. A Junctional Rhythm Caused by Administration of Intravenous Phenytoin. Journal of Emergency Medicine Case Reports. 2018;9(1):10-12. https://izlik.org/JA28UU42SE
Chicago
Dündar, Güllü Akbaydoğan, İbrahim Toker, Hüseyin Narcı, ve Cüneyt Ayrık. 2018. “A Junctional Rhythm Caused by Administration of Intravenous Phenytoin”. Journal of Emergency Medicine Case Reports 9 (1): 10-12. https://izlik.org/JA28UU42SE.
EndNote
Dündar GA, Toker İ, Narcı H, Ayrık C (01 Ocak 2018) A Junctional Rhythm Caused by Administration of Intravenous Phenytoin. Journal of Emergency Medicine Case Reports 9 1 10–12.
IEEE
[1]G. A. Dündar, İ. Toker, H. Narcı, ve C. Ayrık, “A Junctional Rhythm Caused by Administration of Intravenous Phenytoin”, Journal of Emergency Medicine Case Reports, c. 9, sy 1, ss. 10–12, Oca. 2018, [çevrimiçi]. Erişim adresi: https://izlik.org/JA28UU42SE
ISNAD
Dündar, Güllü Akbaydoğan - Toker, İbrahim - Narcı, Hüseyin - Ayrık, Cüneyt. “A Junctional Rhythm Caused by Administration of Intravenous Phenytoin”. Journal of Emergency Medicine Case Reports 9/1 (01 Ocak 2018): 10-12. https://izlik.org/JA28UU42SE.
JAMA
1.Dündar GA, Toker İ, Narcı H, Ayrık C. A Junctional Rhythm Caused by Administration of Intravenous Phenytoin. Journal of Emergency Medicine Case Reports. 2018;9:10–12.
MLA
Dündar, Güllü Akbaydoğan, vd. “A Junctional Rhythm Caused by Administration of Intravenous Phenytoin”. Journal of Emergency Medicine Case Reports, c. 9, sy 1, Ocak 2018, ss. 10-12, https://izlik.org/JA28UU42SE.
Vancouver
1.Güllü Akbaydoğan Dündar, İbrahim Toker, Hüseyin Narcı, Cüneyt Ayrık. A Junctional Rhythm Caused by Administration of Intravenous Phenytoin. Journal of Emergency Medicine Case Reports [Internet]. 01 Ocak 2018;9(1):10-2. Erişim adresi: https://izlik.org/JA28UU42SE