A Toxic Combination

Zeineh examines the case of 73-year-old man with a known history of chronic obstructive pulmonary disease. He was promptly intubated by the emergency department physicians, placed on mechanical ventilation, and given intravenous levofloxacin and corticosteroids. He was transferred to the medical int...

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Bibliographic Details
Published inThe American journal of medicine Vol. 123; no. 8; pp. 707 - 708
Main Author Zeineh, Nabil S., MD
Format Journal Article
LanguageEnglish
Published New York, NY Elsevier Inc 01.08.2010
Elsevier
Elsevier Sequoia S.A
Subjects
Aged
Amiodarone - therapeutic use
Anti-Arrhythmia Agents - therapeutic use
Anti-Bacterial Agents - adverse effects
Biological and medical sciences
Cardiac arrhythmia
Chronic obstructive pulmonary disease
Drug Therapy, Combination - adverse effects
Electrocardiography
General aspects
Heart Conduction System - drug effects
Humans
Internal Medicine
Male
Medical sciences
Myocardial Ischemia - complications
Ofloxacin - adverse effects
Pulmonary Disease, Chronic Obstructive - complications
Torsades de Pointes - complications
Medicine
Toxicity
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Summary:Zeineh examines the case of 73-year-old man with a known history of chronic obstructive pulmonary disease. He was promptly intubated by the emergency department physicians, placed on mechanical ventilation, and given intravenous levofloxacin and corticosteroids. He was transferred to the medical intensive care unit for management. An electrocardiogram (ECG) taken at admission showed signs of left ventricular hypertrophy and a QT interval corrected for heart rate of 450 msec. The patient's ECG changes and arrhythmia were multifactorial in etiology. Specifically, the diagnosis was levofloxacin-induced QT prolongation in the context of severe left ventricular dysfunction and chronic amiodarone therapy. The administration of levofloxacin in combination with amiodarone therapy precipitated the patient's ECG changes and arrhythmia.
ISSN:0002-9343
1555-7162
DOI:10.1016/j.amjmed.2010.03.002