Pediatric flecainide toxicity from a double dose
A 23-month-old boy was brought to the emergency department of an adult and pediatric tertiary care center 1 hour after an inadvertent “double dose” of 120 mg flecainide (9.2 mg/kg). His electrocardiogram revealed sinus rhythm with a terminal R wave in aVR greater than 7 mm, a bifascicular block, and...
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| Veröffentlicht in: | The American journal of emergency medicine 2012-11, Vol.30 (9), p.2095.e1-2095.e2 |
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| container_issue | 9 |
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| container_title | The American journal of emergency medicine |
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| creator | Close, Benjamin R., BPharm, MBBS Banks, Colin J., MBBS |
| description | A 23-month-old boy was brought to the emergency department of an adult and pediatric tertiary care center 1 hour after an inadvertent “double dose” of 120 mg flecainide (9.2 mg/kg). His electrocardiogram revealed sinus rhythm with a terminal R wave in aVR greater than 7 mm, a bifascicular block, and prolonged QRS and QTc intervals. A dramatic improvement in the bifascicular block and terminal R wave occurred after the administration of sodium bicarbonate. He was discharged after 36 hours with no complications. This case demonstrates that flecainide can cause significant cardiac conduction disturbances in doses much lower than previously described. All supratherapeutic ingestions should be assessed in hospital. |
| doi_str_mv | 10.1016/j.ajem.2012.01.005 |
| format | Article |
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His electrocardiogram revealed sinus rhythm with a terminal R wave in aVR greater than 7 mm, a bifascicular block, and prolonged QRS and QTc intervals. A dramatic improvement in the bifascicular block and terminal R wave occurred after the administration of sodium bicarbonate. He was discharged after 36 hours with no complications. This case demonstrates that flecainide can cause significant cardiac conduction disturbances in doses much lower than previously described. 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| subjects | Anti-Arrhythmia Agents - therapeutic use Anti-Arrhythmia Agents - toxicity Arrhythmias, Cardiac - chemically induced Arrhythmias, Cardiac - drug therapy Asymptomatic Cardiac arrhythmia Drug overdose Electrocardiography Emergency Emergency medical care Emergency Service, Hospital Flecainide - poisoning Flecainide - therapeutic use Flecainide - toxicity Heart - drug effects Heart - physiopathology Hemodynamics Humans Infant Male Pediatrics Prescription Drug Misuse Sinuses Sodium Sodium Bicarbonate - therapeutic use Toxicity Vital signs |
| title | Pediatric flecainide toxicity from a double dose |
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