Methadone induced torsade de pointes in a patient receiving antiretroviral therapy.
Adverse drug reactions account for approximately 5% of acute medical admissions. A 34-year-old male patient receiving antiretroviral therapy, methadone and flurazepam presented to the emergency room following collapse with associated loss of consciousness. Cardiac monitoring demonstrated marked Q-T prolongation followed by the cardiac arrhythmia, torsade de pointes. The patient made a full recovery following withdrawal of the antiretroviral therapy and a reduction in methadone dose. Methadone is a recognised cause of this potentially fatal cardiac arrhythmia which is more likely to occur when methadone metabolism is inhibited by drugs such as HIV tease inhibitors.
Falconer
M
M
St James's Hospital, Dublin.
Molloy
D
D
Ingerhaug
J
J
Barry
M
M
D000328:Adult; D044966:Anti-Retroviral Agents / Q000008:administration & dosage / Q000009:adverse effects*; D004347:Drug Interactions; D006801:Humans; D008297:Male; D008691:Methadone / Q000008:administration & dosage / Q000009:adverse effects*; D009294:Narcotics / Q000008:administration & dosage / Q000009:adverse effects*; D015819:Substance Abuse, Intravenous / Q000534:rehabilitation; D016171:Torsades de Pointes / Q000139:chemically induced*
D044966:Anti-Retroviral Agents; D009294:Narcotics; D008691:Methadone