Torsade de pointes associated with Astemizole overdose treated with magnesium sulfate.
Astemizole (Hismanal-Janssen, New Brunswick, NJ) is a nonsedating antihistamine that has the advantage of a once-daily dosage schedule. This article reports the case of a 14-year-old female who intentionally ingested 270 mg of Astemizole and developed torsade de pointes, a form of polymorphic ventricular tachycardia that is associated with prolongation of the QTc interval. She was successfully treated with magnesium sulfate infusion and had an uneventful recovery over a period of 36 hours. This case illustrates that Astemizole overdose is not benign and should be considered in the differential diagnosis of ventricular tachyarrhythmias. Use of high-dose Astemizole may not be advisable for patients who are at risk for prolongation of the QTc interval.
Hasan
R A
RA
Michigan State University College of Human Medicine/Hurley Medical Center, Flint.
Zureikat
G Y
GY
Nolan
B M
BM
D000293:Adolescent; D016589:Astemizole / Q000506:poisoning*; D062787:Drug Overdose; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008278:Magnesium Sulfate / Q000627:therapeutic use*; D011041:Poisoning / Q000188:drug therapy; D016171:Torsades de Pointes / Q000139:chemically induced* / Q000188:drug therapy / Q000503:physiopathology
D008278:Magnesium Sulfate; D016589:Astemizole