本月课程 1：多奈哌齐引起的 QT 间期延长：跌倒的一个可逆原因？
Lesson of the month 1: Prolonged QT syndrome due to donepezil: a reversible cause of falls?
机构信息
Chesterfield Royal Hospital NHS Foundation Trust, Chesterfield, UK
Airedale General Hospital, Keighley, UK.
出版信息
Clin Med (Lond). 2019 Jan;19(1):80-81. doi: 10.7861/clinmedicine.19-1-80.
Abstract
Prolonged QT syndrome precipitates cardiac arrhythmias such as torsades de pointes (TdP) resulting in cardiogenic syncope or sudden death. We report a case of prolonged QT syndrome caused by donepezil which resulted in a fall and hip fracture. In this case female sex, advanced age and diuretic use may have increased the risk of recurrent syncope and potential underlying TdP. Cessation of donepezil resulted in normalisation of the QT interval. This case highlights a lesser known side effect of this dementia drug. It also reminds us of the importance of taking a thorough drug history while considering potential drug toxicity/interactions as part of the comprehensive geriatric assessment.
摘要
长 QT 综合征可引发尖端扭转型室性心动过速（TdP）等心律失常，导致心源性晕厥或猝死。我们报告了一例由多奈哌齐引起的长 QT 综合征病例，该病例导致跌倒和髋部骨折。在该病例中，女性、高龄和使用利尿剂可能增加了反复晕厥和潜在 TdP 的风险。停止使用多奈哌齐后，QT 间期恢复正常。该病例突出了这种痴呆症药物的一个鲜为人知的副作用。它还提醒我们，在考虑潜在的药物毒性/相互作用时，作为综合老年评估的一部分，详细了解药物史的重要性。
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