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与大剂量美沙酮使用相关的多形性室性心动过速

Polymorphic Ventricular Tachycardia Associated with High-Dose Methadone Use.

作者信息

Tam Weng-Chio, Lam U-Po, Mok Toi-Meng, Chang Tou, Ho Wa, De Brito Lima Evora Mario Alberto

机构信息

Department of Cardiology, Centro Hospitalar Conde São Januário, Macau, SAR, China.

出版信息

Case Rep Cardiol. 2020 Sep 23;2020:4504657. doi: 10.1155/2020/4504657. eCollection 2020.

Abstract

Methadone is a well-tolerated drug that has been used for pain control and the treatment of opioid addiction. However, some fatal cardiac side effects have been reported previously, including ventricular arrhythmia, stress cardiomyopathy, and coronary artery disease. We reported a middle-aged woman receiving high-dose methadone whom was presented with QT prolongation and torsade de pointes. We replaced the methadone with benzodiazepine and gave lidocaine use simultaneously. Thus, QT interval was shortened within the normal limit. Methadone-induced torsade de pointes is a rare but serious event, and QT interval should be monitored periodically to prevent this fatal adverse event, especially some patients with high-dose methadone use.

摘要

美沙酮是一种耐受性良好的药物,已被用于疼痛控制和阿片类药物成瘾的治疗。然而,此前已有一些致命的心脏副作用报道,包括室性心律失常、应激性心肌病和冠状动脉疾病。我们报告了一名接受高剂量美沙酮治疗的中年女性,她出现了QT间期延长和尖端扭转型室性心动过速。我们用苯二氮䓬类药物替代了美沙酮,并同时使用利多卡因。因此,QT间期缩短至正常范围内。美沙酮诱发的尖端扭转型室性心动过速是一种罕见但严重的事件,应定期监测QT间期以预防这种致命的不良事件,尤其是在一些使用高剂量美沙酮的患者中。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7428/7532395/99a69e908085/CRIC2020-4504657.001.jpg

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