Tiotropium bromide overdose
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Tachycardia in an elderly patient with atrial fibrillation after inadvertent overdose: case report A 74-year-old man with atrial fibrillation, hospitalised for increased heart rate and shortness of breath, developed tachycardia following an inadvertent overdose of inhaled tiotropium. Upon admission, the man’s heart rate was stabilised at 80–90 beats/min with metoprolol succinate. Fifteen minutes after accidentally receiving 90 µg of inhaled tiotropium in a single dose, his heart rate increased from 80 to 160 beats/min. The man’s creatinine clearance was estimated to be below 50 mL/min. The man was stabilised and discharged after 5 days of treatment with physostigmine, metoprolol tartrate and diltiazem. Eleven days after the overdose, the man’s heart rate was in the 40s and the atrioventricular nodal blocking agents were decreased proportionately. Author comment: "Use of the Naranjo probability scale confirmed a causative relationship as a probable drug effect." Gregory MD, et al. Accidental overdose of tiotropium in a patient with atrial fibrillation. Annals of Pharmacotherapy 44: 391-393, No. 2, Feb 2010. Available 803013471 from: URL: http://dx.doi.org/10.1345/aph.1m409 - USA
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Reactions 8 May 2010 No. 1300
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