title: Torsades de pointes induced by concomitant use of chlorpheniramine and propranolol: An unusual presentation with no QT prolongation.
abstract: Drug-induced torsades de pointes (TdP) is a rare but potentially fatal adverse effect of commonly prescribed medications including cardiac and noncardiac drugs. Importantly, many drugs have been reported to cause the characteristic Brugada syndrome-linked electrocardiography (ECG) abnormalities and/or (fatal) ventricular tachyarrhythmias. Chlorpheniramine and propranolol have the arrhythmogenic effects reported previously. A review of literature revealed a large number of case reports of chlorpheniramine or propranolol use resulting in QTc prolongation, TdP, or both. However, we wish to report the case of a patient who was treated with a combination of chlorpheniramine and propranolol, whose ECG showed no QT prolongation but who suffered from cardiac arrest due to TdP.
authors.affiliation: Department of Cardiology, Siyami Ersek Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, Istanbul, Turkey.
authors.forename: Altuğ
authors.initials: A
authors.lastname: Ösken
authors.affiliation: Department of Cardiology, Siyami Ersek Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, Istanbul, Turkey.
authors.forename: Nizamettin Selçuk
authors.initials: NS
authors.lastname: Yelgeç
authors.affiliation: Department of Cardiology, Siyami Ersek Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, Istanbul, Turkey.
authors.forename: Regayip
authors.initials: R
authors.lastname: Zehir
authors.affiliation: Department of Cardiology, Siyami Ersek Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, Istanbul, Turkey.
authors.forename: Tuğba Kemaloğlu
authors.initials: TK
authors.lastname: Öz
authors.affiliation: Department of Internal Medicine, Rize Findikli Goiter Research Center, Rize, Turkey.
authors.forename: Selçuk
authors.initials: S
authors.lastname: Yaylacı
authors.affiliation: Department of Cardiology, Sakarya University Faculty of Medicine, Sakarya, Turkey.
authors.forename: Ramazan
authors.initials: R
authors.lastname: Akdemir
authors.affiliation: Department of Cardiology, Sakarya University Faculty of Medicine, Sakarya, Turkey.
authors.forename: Hüseyin
authors.initials: H
authors.lastname: Gündüz
mesh_terms: D000328:Adult; D002744:Chlorpheniramine / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D017147:Defibrillators, Implantable; D004562:Electrocardiography; D006323:Heart Arrest / Q000139:chemically induced* / Q000175:diagnosis / Q000628:therapy; D006801:Humans; D008297:Male; D011433:Propranolol / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D016171:Torsades de Pointes / Q000139:chemically induced* / Q000175:diagnosis / Q000628:therapy; D016896:Treatment Outcome
chemical_list: D002744:Chlorpheniramine; D011433:Propranolol
keywords: Chlorpheniramine; drug-induced torsades de pointes; propranolol