title: Paranoid psychosis and myoclonus: flecainide toxicity in renal failure.
abstract: Flecainide is a sodium channel blocker used mainly in the treatment of supraventricular arrhythmias. Central nervous system side effects such as dizziness, visual disturbances, headache and nausea are commonly associated with flecainide, but severe central nervous system toxicity is rare. We report the first case of flecainide toxicity in a patient with end-stage renal failure. Cessation of flecainide therapy resulted in a fall in serum flecainide levels, with associated resolution of adverse central nervous system effects. We also review the pharmacokinetics of flecainide in patients with chronic kidney disease.
authors: Department of Nephrology and Transplantation, Guy's and St Thomas's NHS Foundation Trust, London, UK. stephenting@doctors.org.uk
authors: Stephen M S
authors: SM
authors: Ting
authors: Douglas
authors: D
authors: Lee
authors: Douglas
authors: D
authors: Maclean
authors: Neil S
authors: NS
authors: Sheerin
mesh_terms: D000889:Anti-Arrhythmia Agents / Q000009:adverse effects / Q000097:blood / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D005424:Flecainide / Q000009:adverse effects* / Q000097:blood / Q000627:therapeutic use; D005500:Follow-Up Studies; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007676:Kidney Failure, Chronic / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D008875:Middle Aged; D009207:Myoclonus / Q000139:chemically induced* / Q000503:physiopathology; D010259:Paranoid Disorders / Q000139:chemically induced* / Q000503:physiopathology; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000379:methods; D018570:Risk Assessment
chemical_list: D000889:Anti-Arrhythmia Agents; D007004:Hypoglycemic Agents; D005424:Flecainide