QT prolongation and development of torsades de pointes with the concomitant administration of oral erythromycin base and quinidine.
Torsades de pointes is a polymorphic ventricular tachycardia characterized by marked QT prolongation on the electrocardiogram. It can be induced by both antiarrhythmic and nonantiarrhythmic drugs, such as quinidine and erythromycin. No extensive literature documents an interaction between quinidine and erythromycin when the agents are administered orally. A 95-year-old man received oral quinidine and erythromycin for the treatment of atrial fibrillation and community-acquired pneumonia. He developed torsades de pointes and subsequently cardiac arrest. Since erythromycin and quinidine are known to cause arrhythmias individually, caution and close monitoring are necessary when the drugs are administered concomitantly.
Lin
J C
JC
College of Pharmacy, University of Illinois, Chicago, USA.
Quasny
H A
HA
D000368:Aged; D000369:Aged, 80 and over; D000889:Anti-Arrhythmia Agents / Q000009:adverse effects* / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000150:complications / Q000188:drug therapy; D017714:Community-Acquired Infections / Q000150:complications / Q000188:drug therapy; D004347:Drug Interactions; D004562:Electrocardiography; D004917:Erythromycin / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D008133:Long QT Syndrome / Q000139:chemically induced*; D008297:Male; D011014:Pneumonia / Q000150:complications / Q000188:drug therapy; D011802:Quinidine / Q000009:adverse effects* / Q000627:therapeutic use; D016171:Torsades de Pointes / Q000139:chemically induced*
D000889:Anti-Arrhythmia Agents; D000900:Anti-Bacterial Agents; D004917:Erythromycin; D011802:Quinidine