Flecainide/unspecified complementary feed interaction
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Various toxicities: 3 case reports In a case series of children diagnosis with a supraventricular tachycardia from March 2017 to June 2019, a girl and 2 boys aged approximately 25 days–6 months were described, who developed irritability, dyspnoea, prolongation of QTc interval, febrile episode, sinus bradycardia, prolongation of PR interval, decay, respiratory distress, variable atrioventricular block, right bundle branch block, reduced cardiac output, monomorphic ventricular tachycardia or decrease in blood pressure following flecainide intoxication during treatment with flecainide for supraventricular tachycardia (SVT). Out of these 3 patients, 1 patients exhibited administration error while receiving flecainide and one patient exhibited drug food interactions following concomitant administration of flecainide and unspecified complementary feed [duration of treatment to reaction onset not stated; not all outcomes stated]. Case 1: An approximately 25-day-old girl developed irritability, dyspnoea, prolongation of PR interval and prolonged QTc interval following flecainide intoxication during treatment with flecainide for supraventricular tachycardia. The girl was diagnosed with SVT when she was 3-day-old and initially treated with propranolol. Additionally, flecainide was initiated due to recurrences of the SVT. She was subsequently discharged on day 10 of her life on propranolol and oral flecainide 3.3 mg/kg per day liquid solution of 20 mg/mL. Thereafter, she was presented to emergency room on day 25 of her life due to irritability and dyspnoea. Her initials vitals were normal. Subsequent ECG demonstrated sinus rhythm with a prolongation of PR interval, complete right bundle branch and a prolongation of the QTc interval. Her serum flecainide concentration was found to be 0.72 mcg/mL after 18 hours of the latest ingestion. Eventually, ECG had normalised and condition improved after flecainide suppression and she was discharged on propranolol without recurrence of the SVT. Her family reported there was no error in the flecainide administration schedule. Hence, it was concluded that flecainide intoxication resulted in irritability, dyspnoea, prolongation of PR interval and prolongation of QTc interval. Case 2: A 6-month-old boy developed febrile episode, sinus bradycardia with prolongation of PR interval, prolongation of QTc interval and complete right bundle branch block following flecainide intoxication during treatment with flecainide for supraventricular tachycardia. Additionally, he exhibited drug food interactions following concomitant administration of flecainide and unspecified complementary feed. The boy was diagnosed with SVT and initially treated with propranolol. Additionally, he started receiving flecainide [route not stated] 3.6 mg/kg per day liquid preparation of 20 mg/mL due to recurrent SVT. Subsequently, he was presented with a febrile episode without vomiting or diarrhoea. His ECG demonstrated sinus bradycardia with prolongation of PR interval, prolongation of QTc interval and a complete righ
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