Methadone-induced torsades de pointes: a twist of fate.
نویسندگان
چکیده
A case of methadone-induced torsades de pointes is presented to demonstrate clinical features that predispose patients to this serious cardiac arrhythmia. A patient who was receiving methadone maintenance treatment for heroin addiction presented to the hospital with dizziness and near-syncope. He was taking a relatively high dose of methadone but was not taking any concomitant cytochrome P450 inhibitor or QT-prolonging drugs. He had prolonged corrected QT interval, hypokalemia, and hypomagnesemia on admission and was later found to have severe left ventricular dysfunction. On admission to a telemetry unit, the patient experienced chest discomfort and palpitations with corresponding torsades de pointes that was terminated with correction of hypokalemia and hypomagnesemia. The corrected QT interval became shorter but remained profoundly prolonged until methadone was substituted with buprenorphine.
منابع مشابه
Methadone induced torsades de pointes and ventricular fibrillation: A case review
BACKGROUND Methadone is a synthetic opioid, which has been successfully used in treating heroin addiction and chronic pain syndrome in palliative care for more than 30 years. This drug is a potent blocker of the delayed rectifier potassium ion channel, which may result in corrected QT (QTc) interval prolongation and increased risk of torsades de pointes (TdP) in susceptible individuals. CASE ...
متن کاملMethadone-induced Torsades de pointes.
Torsades de pointes is a polymorphic ventricular tachycardia that can quickly evolve into ventricular fibrillation and sudden death. This arrhythmia often occurs secondary to medication- induced cardiac repolarization dysfunction with resultant prolonged QTc interval on ECG. Numerous medications can predispose patients to this deadly tachycardia. We report a case of methadone-induced Torsades d...
متن کامل[Torsades de pointes during methadone treatment].
Methadone is a synthetic opioid that has been used successfully to treat heroin addiction and chronic pain. It is usually well tolerated and has few side effects. Recently, an association with torsade de pointes has been reported. We present 4 cases of torsade de pointes during methadone treatment.
متن کاملDose-Dependent Effects of Methadone on QT interval in Patients under Methadone Maintenance Treatment
Background: The role of methadone in QTc prolongation, Torsades de Pointes (TdP) arrhythmia and sudden cardiac death has been debated. Because of widespread use of methadone in methadone maintenance treatment (MMT) centers, we aimed to study dose-related effects of methadone on QTc prolongation. Methods: In a comparative observational study, 90 patients who were under MMT were evaluated. Patien...
متن کاملAtrio-Ventricular Block-Induced Torsades de Pointes: An Update
Torsades de pointes is a potentially life threatening form of rapid, polymorphic ventricular tachycardia. Literally meaning “twisting of the points”, torsades de pointes is electrocardiographically characterized by QRS axis undulations over runs of several beats, with a specific twist of the QRS complex around the isoelectric baseline. The definition also requires that an abnormal QT-prolongati...
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ورودعنوان ژورنال:
- Heart & lung : the journal of critical care
دوره 40 5 شماره
صفحات -
تاریخ انتشار 2011