Department of Emergency and Critical Care Medicine, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, Japan.
Clin Toxicol (Phila). 2010 Feb;48(2):149-52. doi: 10.3109/15563650903524126.
Eperisone hydrochloride is a centrally acting muscle relaxant, and triazolam is a short-acting benzodiazepine. Although commonly prescribed, cardiotoxicity induced by a single overdose of either drug is comparatively rare. A patient receiving nifedipine developed torsades de pointes (TdP) because of prolongation of the corrected QT (QTc) interval after an overdose of eperisone hydrochloride and triazolam.
A 60-year-old man receiving nifedipine was admitted in a comatose condition 3 h after ingesting 5,000 mg of eperisone and 2.5 mg of triazolam. Electrocardiogram showed sinus rhythm with prolongation of the QTc interval (820 ms). The serum electrolyte levels were as follows: potassium, 3.8 mEq/L; magnesium, 2.4 mg/dL. The serum drug concentrations were high: eperisone, 15,360 ng/mL; triazolam, 110.8 ng/mL. A temporary cardiac pacemaker was implanted immediately after the development of TdP, 11 h after the ingestion. The serum triazolam concentration normalized on day 2. The QTc interval and eperisone concentration normalized on day 6.
Eperisone and triazolam overdose can cause life-threatening cardiotoxicity. Electrocardiographic monitoring and serial determination of QTc interval are likely the best way to observe these patients and evaluate the risk of cardiotoxicity.
盐酸乙哌立松是一种中枢作用的肌肉松弛剂，三唑仑是一种短效苯二氮䓬类药物。虽然这两种药物经常被开处方，但单一过量使用引起的心脏毒性相对较少见。一名接受硝苯地平治疗的患者因盐酸乙哌立松和三唑仑过量导致校正 QT（QTc）间期延长而发生尖端扭转型室性心动过速（TdP）。
一名 60 岁男性在服用 5000 毫克盐酸乙哌立松和 2.5 毫克三唑仑后昏迷 3 小时入院。心电图显示窦性心律伴 QTc 间期延长（820ms）。血清电解质水平如下：钾，3.8mEq/L；镁，2.4mg/dL。血清药物浓度较高：盐酸乙哌立松 15360ng/mL；三唑仑 110.8ng/mL。在 TdP 发生后 11 小时立即植入临时心脏起搏器。第 2 天血清三唑仑浓度恢复正常。第 6 天 QTc 间期和盐酸乙哌立松浓度恢复正常。
盐酸乙哌立松和三唑仑过量可导致危及生命的心脏毒性。心电图监测和 QTc 间期的连续测定可能是观察这些患者和评估心脏毒性风险的最佳方法。
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