Atrioventricular block following overdose of decongestant cold medication.
A 24-year-old man developed high-degree atrioventricular (A-V) block with a pulse rate of 40 beats per minute and hypertension following an overdose of a combination decongestant cold medication that contained phenylpropanolamine, phenylephrine, chlorpheniramine, and phenyltoloxamine. The patient was treated with ipecac, activated charcoal, and cathartics in the emergency department (ED). After his admission to the coronary care unit, the A-V block gradually resolved to sinus rhythm with periods of second-degree block, Mobitz types I and II. No treatment was required. The patient had a normal sinus rhythm and normal blood pressure prior to discharge.
B T
BT
Burton
M
M
Rice
L E
LE
Schmertzler
D000328:Adult; D001559:Benzhydryl Compounds / Q000506:poisoning; D002744:Chlorpheniramine / Q000506:poisoning; D004338:Drug Combinations; D006327:Heart Block / Q000209:etiology*; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D007486:Ipecac / Q000627:therapeutic use; D008297:Male; D014663:Nasal Decongestants / Q000506:poisoning*; D010656:Phenylephrine / Q000506:poisoning; D010665:Phenylpropanolamine / Q000506:poisoning
D001559:Benzhydryl Compounds; D004338:Drug Combinations; D014663:Nasal Decongestants; D010656:Phenylephrine; D010665:Phenylpropanolamine; D002744:Chlorpheniramine; D007486:Ipecac; C008865:phenyltoloxamine