The use of isoproterenol and phenytoin to reverse torsade de pointes.
Torsade de pointes is a form of polymorphic ventricular tachycardia that differs from other forms of ventricular tachycardia in its morphology, precipitating factors, and therapeutic approach. Its recognition is of utmost importance, as the standard anti-arrythmic drugs not only might be ineffective in its termination but also may aggravate it. Herein, we report a case of antipsychotic-induced torsade de pointes and describe the use of magnesium sulfate, isoproterenol, and phenytoin and their proposed mechanism of action.
Internal Medicine Department, Mercy Medical Center, Clinton, IA, USA. Electronic address: hesham_omar2003@yahoo.com.
Hesham R
HR
Omar
Anesthesia Department, Tampa General Hospital and Florida Gulf to Bay Anesthesiology Associates LLC, Tampa, FL, USA.
Collin
C
Sprenker
Anesthesia Department, Tampa General Hospital and Florida Gulf to Bay Anesthesiology Associates LLC, Tampa, FL, USA.
Rachel
R
Karlnoski
Anesthesia Department, Tampa General Hospital and Florida Gulf to Bay Anesthesiology Associates LLC, Tampa, FL, USA.
Devanand
D
Mangar
Department of Surgery/Anesthesiology, Department of Molecular Pharmacology and Physiology, University of South Florida, Tampa, FL, USA.
Enrico M
EM
Camporesi
D000328:Adult; D014150:Antipsychotic Agents / Q000009:adverse effects; D002316:Cardiotonic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D004562:Electrocardiography; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D007545:Isoproterenol / Q000008:administration & dosage / Q000627:therapeutic use*; D010672:Phenytoin / Q000008:administration & dosage / Q000627:therapeutic use*; D016171:Torsades de Pointes / Q000139:chemically induced / Q000188:drug therapy* / Q000503:physiopathology; D061567:Voltage-Gated Sodium Channel Blockers / Q000009:adverse effects / Q000627:therapeutic use*
D014150:Antipsychotic Agents; D002316:Cardiotonic Agents; D061567:Voltage-Gated Sodium Channel Blockers; D010672:Phenytoin; D007545:Isoproterenol