Franco Vanessa
Emergency Medicine, UCLA Medical Center, Los Angeles, CA.
Am J Emerg Med. 2015 Oct;33(10):1540.e3-5. doi: 10.1016/j.ajem.2015.07.063. Epub 2015 Jul 30.
Here we describe a wide complex tachycardia after bupropion overdose that was responsive to sodium bicarbonate. This rhythm was likely secondary to bupropion-induced sodium channel blockade and corrected QT interval (QTc) prolongation. It is critical for the emergency medicine physician to recognize that a wide complex rhythm in a patient with bupropion overdose may be secondary to sodium channel toxicity and prolonged QTc as this rhythm may be responsive to sodium bicarbonate. Identifying this rhythm as purely ventricular tachycardia can lead to the administration of medications such as amiodarone that may further prolong QTc and contribute to sodium channel blockade, exacerbating bupropion-induced cardiotoxicity.
在此，我们描述了一例服用安非他酮过量后出现的宽QRS波心动过速，该心动过速对碳酸氢钠治疗有效。这种心律失常可能继发于安非他酮诱导的钠通道阻滞和校正QT间期（QTc）延长。对于急诊医生来说，认识到服用安非他酮过量患者出现的宽QRS波心律可能继发于钠通道毒性和QTc延长至关重要，因为这种心律可能对碳酸氢钠治疗有效。将这种心律单纯识别为室性心动过速可能会导致使用诸如胺碘酮等药物，这些药物可能会进一步延长QTc并导致钠通道阻滞，从而加重安非他酮诱导的心脏毒性。
