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題 名 | A Lethal Complication of Torsade de Pointes Ventricular Tachycardia by Combined Use of Terfenadine and Erythromycin--A Case Report=第二代抗組織氨毒性引起之多型態性心室過速--一病例報告 |
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作 者 | 璩大維; 汪文斌; 丁予安; | 書刊名 | Acta Cardiologica Sinica |
卷 期 | 13:3 民86.07-09 |
頁 次 | 頁152-156 |
分類號 | 418.1 |
關鍵詞 | 第二代抗組織氨-terfenadine; 多型態性心室過速; 早期後去極化; Terfenadine; Torsades de pointes; Early afterdepolarization; |
語 文 | 英文(English) |
中文摘要 | 背景:第二代抗組織氨-Terfenadine,和常用於上呼吸道的紅黴素-Erythromycin合併服用時,可能會產生致死的多型態性心室過速;在歐美已有數例報導,而國內正常人合併服用後產生致死的多型態性心室過速尚為首例。 病例報告:一名心臟正常的十二歲男孩在吃了三天感冒藥以後,居然發生了罕見的多型態性心室過速合併休克。仔細探究其感冒藥物成份,發現有超過標準劑量的第二代抗組織氨-Terfenadine,和常用於上呼吸道的紅黴素-Erythromycin。此男孩在急診室經過電擊和抗心律不整藥物處理之後,呈現竇性心律,而QTc間隔也在三天後恢復正常,一個月後QTc間隔仍是正常。本病例報告將討論第二代抗組織氨造成心臟毒性之機轉,以及第二代抗組織氨與其他藥物共用時所容易導致之併發症。 結論:期望醫界同仁能夠明瞭第二代抗組織氨之心臟毒性,而儘量謹慎用藥以避免發生不幸。 |
英文摘要 | Background. Torsades de Pointes (TdP), a life-threatening polymorphic ventricular tachycardia, can be caused by Terfenadine overdose or Terfenadine interaction with Erythromycin or Ketoconazole. This report is of a case in which the patient developed TdP after receiving both Terfenadine and Erythromycin for three days. Methods and Results. A 12-year-old boy developed QTc prolongation for 0.66 milliseconds(ms) and TdP after taking Terfenadine and Erythromycin for three days. He became stabilized after management of emergent cardioversion. The QTc interval reduced to 0.55 ms at the third day after admission, and 0.43 ms about one month later. No congenital cardiovascular abnormality nor electrolyte imbalance was noted. The side effects and toxicity of Terfenadine are discussed here. This is the first case of a normal healthy person developing Terfenadine-induced TdP reported in Taiwan. Conclusion. Complication of Torsade de Pointes ventricular tachycardia was not uncommon with Terfenadine, especially when Erythromycin is given concomitantly. Such a combination of Terfenadine and Erythromycin should be avoided. |
本系統中英文摘要資訊取自各篇刊載內容。