title: Case of polymorphic ventricular tachycardia in diphenhydramine poisoning.
abstract: This is the first reported case of torsades de pointes attributable to diphenhydramine, a drug with weak I(Kr) effects. A 26-year-old, healthy man was admitted to intensive care after a diphenhydramine overdose. Results of physical examination, ECG, and electrolytes were normal at admission. Despite supportive care, he developed typical, sustained, torsades de pointes with a markedly prolonged QT interval requiring cardioversion. Drugs with weak I(Kr)-blocking effects may cause lethal proarrhythmia in susceptible individuals when delivered in high concentrations. This case illustrates the variation in repolarization reserve that exists in a free-standing population.
authors.affiliation: Division of Cardiovascular Diseases, Lankenau Hospital and Institute for Medical Research, Main Line Health Heart Center, Wynnewood, Pennsylvania, USA.
authors.forename: Ajay K
authors.initials: AK
authors.lastname: Joshi
authors.forename: Tatjana
authors.initials: T
authors.lastname: Sljapic
authors.forename: Hassan
authors.initials: H
authors.lastname: Borghei
authors.forename: Peter R
authors.initials: PR
authors.lastname: Kowey
mesh_terms: D000328:Adult; D018926:Anti-Allergic Agents / Q000506:poisoning; D004155:Diphenhydramine / Q000506:poisoning*; D062787:Drug Overdose; D004554:Electric Countershock; D004562:Electrocardiography; D006801:Humans; D020127:Recovery of Function; D013406:Suicide, Attempted; D016171:Torsades de Pointes / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy*
chemical_list: D018926:Anti-Allergic Agents; D004155:Diphenhydramine