QTc prolongation and torsades de pointes due to a coadministration of fluoxetine and amiodarone in a patient with implantable cardioverter-defibrillator Case report and review of the literature
Rationale: Drug-induced prolongation of the corrected QT interval (QTc) may lead to serious and potentially life-threatening ventricular tachyarrhythmia, such as torsades de pointes (Tdp), which is worthy of clinical attention. Here, we report 1 case of Tdp after a coadministration of fluoxetine and amiodarone. Patient concerns: A 62-year-old Chinese male who placed with the implanted cardioverter-defibrillator (ICD) appeared the QTc prolongation and Tdp after the concurrent administration of fluoxetine and amiodarone. Diagnoses: Torsades de pointes (Tdp). Interventions: The patient was treated with magnesium and potassium immediately. Her ICD-brady pacing mode was reprogrammed to 90 bpm. Meanwhile, both of fluoxetine and amiodarone were discontinued. Outcomes: The further episodes of Tdp were prevented. After a few days, the QTc gradually decreased without clinically significant arrhythmias. Lessons: The present case demonstrates that a potential drug-drug interaction (DDI) may lead to a life-threatening drug adverse reaction (ADR) especially in special subjects. Therefore, clinicians should closely monitor the electrocardiogram (ECG) when QTc-prolonging agents are given to patients with cardiac abnormalities, and avoid combining 2 QTc-prolonging drugs.
基金:
Science Fund of Hospital Pharmacy of Shanghai Jiaotong University School of Medicine [JDYX2016ZD003]; Program for Key Discipline of Clinical Pharmacy of Shanghai [2016-40044-002]; Program for Key but Weak Discipline of Shanghai Municipal Commission of Health and Family Planning [2016ZB0304]
第一作者单位:[1]Huazhong Univ Sci & Technol, Tongji Hosp, Dept Pharm, Wuhan, Hubei, Peoples R China
通讯作者:
推荐引用方式(GB/T 7714):
Wei Anhua,Peng Jinlan,Gu Zhichun,et al.QTc prolongation and torsades de pointes due to a coadministration of fluoxetine and amiodarone in a patient with implantable cardioverter-defibrillator Case report and review of the literature[J].MEDICINE.2017,96(49):doi:10.1097/MD.0000000000009071.
APA:
Wei, Anhua,Peng, Jinlan,Gu, Zhichun&Li, Juan.(2017).QTc prolongation and torsades de pointes due to a coadministration of fluoxetine and amiodarone in a patient with implantable cardioverter-defibrillator Case report and review of the literature.MEDICINE,96,(49)
MLA:
Wei, Anhua,et al."QTc prolongation and torsades de pointes due to a coadministration of fluoxetine and amiodarone in a patient with implantable cardioverter-defibrillator Case report and review of the literature".MEDICINE 96..49(2017)