Methadone
- PDF / 141,659 Bytes
- 1 Pages / 595.245 x 841.846 pts (A4) Page_size
- 75 Downloads / 197 Views
1
S
Torsade de pointes and QTc prolongation: case report A 61-year-old man developed torsade de pointes (TdP) and QTc prolongation while receiving methadone. The man, whose extensive medical history included heroin use, had been receiving maintenance methadone 110 mg/day for an unspecified length of time [route not stated]. He presented to an emergency department (ED) after experiencing two episodes of dizziness and nearsyncope. The first episode, lasting for less than 1 minute, had happened the previous night; the second similar episode, with additional bladder incontinence, had occurred the following day, after which he was brought to the ED. On presentation, he had an irregular pulse, a grade 2/6 holosystolic murmur, few scattered rhonchi, anaemia, hypokalaemia and hypomagnesaemia. A normal sinus rhythm with atrial bigeminy and a QTc of 626 msec was noted on an ECG, and he was admitted to a telemetry unit. He experienced TdP-associated palpitations and chest pain later that evening. The man received potassium and magnesium. His TdP resolved and a repeat ECG showed improvement of his QTc prolongation (538 msec). Methadone was initially switched for a morphine taper. All opioid medications were subsequently stopped, and buprenorphine was started within a few days. Due to severe left ventricular dysfunction, he also started receiving metoprolol and his regular lisinopril dose was increased. After 5 months, an ECG showed sinus bradycardia with marginal QTc prolongation (443 msec). Thanavaro KL, et al. Methadone-induced torsades de pointes: A twist of fate. Heart and Lung 40: 448-453, No. 5, Sep-Oct 2011. Available from: URL: http:// 803061792 dx.doi.org/10.1016/j.hrtlng.2010.12.008 - USA
0114-9954/10/1375-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved
Reactions 29 Oct 2011 No. 1375
Data Loading...
