ECG manifestations: The poisoned patient

Emergency Medicine Clinics of North America

Volumn 24, Issue 1, 2006, Pages 159-177

  Holstege, Christopher P ^a   Eldridge, David L ^a   Rowden, Adam K ^a  

^a UNIVERSITY OF VIRGINIA   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ADENOSINE TRIPHOSPHATASE (POTASSIUM SODIUM) INHIBITOR; ADRENERGIC RECEPTOR STIMULATING AGENT; ANTIARRHYTHMIC AGENT; ANTIDEPRESSANT AGENT; ANTIHISTAMINIC AGENT; ARSENIC TRIOXIDE; ATROPINE; BEPRIDIL; BETA ADRENERGIC RECEPTOR BLOCKING AGENT; CALCIUM; CALCIUM CHANNEL BLOCKING AGENT; CARDIAC GLYCOSIDE; CATECHOLAMINE; CHLOROQUINE; CHOLINERGIC RECEPTOR BLOCKING AGENT; CISAPRIDE; CITALOPRAM; COCAINE; DEXTROPROPOXYPHENE; DIPHENHYDRAMINE; GLUCAGON; IMMUNOGLOBULIN F(AB) FRAGMENT; INSULIN; LIDOCAINE; MAGNESIUM SULFATE; NEUROLEPTIC AGENT; POTASSIUM CHANNEL BLOCKING AGENT; QUINOLONE DERIVATIVE; SODIUM CHANNEL BLOCKING AGENT; UNINDEXED DRUG;

ANTICHOLINERGIC SYNDROME; ASYSTOLE; ATRIOVENTRICULAR BLOCK; ATRIOVENTRICULAR JUNCTION ARRHYTHMIA; BRADYCARDIA; CARDIOTOXICITY; CLINICAL FEATURE; COMPREHENSION; CONGESTIVE HEART FAILURE; DEFIBRILLATION; DRUG FATALITY; DRUG INTOXICATION; DRUG SAFETY; ECG ABNORMALITY; FIRST DEGREE ATRIOVENTRICULAR BLOCK; HEART ARREST; HEART ARRHYTHMIA; HEART ATRIUM FIBRILLATION; HEART BLOCK; HEART BUNDLE BRANCH BLOCK; HEART CYCLE; HEART MUSCLE CONDUCTION DISTURBANCE; HEART MUSCLE ISCHEMIA; HEART MUSCLE POTENTIAL; HEART PACING; HEART RIGHT BUNDLE BRANCH BLOCK; HEART VENTRICLE ARRHYTHMIA; HEART VENTRICLE EXTRASYSTOLE; HEART VENTRICLE FIBRILLATION; HEART VENTRICLE TACHYCARDIA; HUMAN; HYPERTENSION; HYPOTENSION; ISCHEMIC HEART DISEASE; MOLECULAR MECHANICS; NONHUMAN; PAROXYSMAL SUPRAVENTRICULAR TACHYCARDIA; PHYSICIAN; POTASSIUM TRANSPORT; PRIORITY JOURNAL; QT PROLONGATION; REVIEW; SCIENCE; SECOND DEGREE ATRIOVENTRICULAR BLOCK; SIDE EFFECT; SINUS BRADYCARDIA; SINUS TACHYCARDIA; SUDDEN DEATH; SUPRAVENTRICULAR TACHYCARDIA; TACHYCARDIA; TORSADE DES POINTES;

EID: 27944502537     PISSN: 07338627     EISSN: 07338627     Source Type: Journal    
DOI: 10.1016/j.emc.2005.08.012     Document Type: Review

References (69)

1. W.A. Watson, T.L. Litovitz, and W. Klein-Schwartz 2003 annual report of the American Association of Poison Control Centers Toxic Exposure Surveillance System Am J Emerg Med 22 5 2004 335 404
2. T.E. Albertson, A. Dawson, and F. de Latorre TOX-ACLS: toxicologic-oriented advanced cardiac life support Ann Emerg Med 37 4 Suppl 2001 S78 S90
3. Y.G. Yap, and A.J. Camm Drug induced QT prolongation and torsades de pointes Heart 89 11 2003 1363 1372
4. M.E. Anderson, S.M. Al-Khatib, and D.M. Roden Cardiac repolarization: current knowledge, critical gaps, and new approaches to drug development and patient management Am Heart J 144 5 2002 769 781
5. F. De Ponti, E. Poluzzi, and N. Montanaro QTc and psychotropic drugs Lancet 356 9223 2000 75 76
6. P. Munro, and C. Graham Torsades de pointes Emerg Med J 19 5 2002 485 486
7. D.E. Kyrmizakis, T.S. Chimona, and E.M. Kanoupakis QT prolongation and torsades de pointes associated with concurrent use of cisapride and erythromycin Am J Otolaryngol 23 5 2002 303 307
8. B.Z. Horowitz, K. Bizovi, and R. Moreno Droperidol - behind the black box warning Acad Emerg Med 9 6 2002 615 618
9. T. Chan W. Brady R. Harrigan ECG in emergency medicine and acute care 2005 Elsevier-Mosby Philadelphia
10. G.D. Sides QT interval prolongation as a biomarker for torsades de pointes and sudden death in drug development Dis Markers 18 2 2002 57 62
11. L.S. Nelson Toxicologic myocardial sensitization J Toxicol Clin Toxicol 40 7 2002 867 879
12. P. Kaye, and I. O'Sullivan The role of magnesium in the emergency department Emerg Med J 19 4 2002 288 291
13. P.F. Kolecki, and S.C. Curry Poisoning by sodium channel blocking agents Crit Care Clin 13 4 1997 829 848
14. W. Zareba, A.J. Moss, and S.Z. Rosero Electrocardiographic findings in patients with diphenhydramine overdose Am J Cardiol 80 9 1997 1168 1173
15. C.M. Stork, J.T. Redd, and K. Fine Propoxyphene-induced wide QRS complex dysrhythmia responsive to sodium bicarbonate - a case report J Toxicol Clin Toxicol 33 2 1995 179 183
16. W. Kerns II, L. Garvey, and J. Owens Cocaine-induced wide complex dysrhythmia J Emerg Med 15 3 1997 321 329
17. R.A. Harrigan, and W.J. Brady ECG abnormalities in tricyclic antidepressant ingestion Am J Emerg Med 17 4 1999 387 393
18. R.M. Heaney Left bundle branch block associated with propoxyphene hydrochloride poisoning Ann Emerg Med 12 12 1983 780 782
19. L. Fernandez-Quero, M.J. Riesgo, and S. Agusti Left anterior hemiblock, complete right bundle branch block and sinus tachycardia in maprotiline poisoning Intensive Care Med 11 4 1985 220 222
20. W.J. Brady, and J. Skiles Wide QRS complex tachycardia: ECG differential diagnosis Am J Emerg Med 17 4 1999 376 381
21. R.F. Clark, and M.V. Vance Massive diphenhydramine poisoning resulting in a wide-complex tachycardia: successful treatment with sodium bicarbonate Ann Emerg Med 21 3 1992 318 321
22. A.K. Joshi, T. Sljapic, and H. Borghei Case of polymorphic ventricular tachycardia in diphenhydramine poisoning J Cardiovasc Electrophysiol 15 5 2004 591 593
23. E.L. Liebelt, P.D. Francis, and A.D. Woolf ECG lead in aVR versus QRS interval in predicting seizures and arrhythmias in acute tricyclic antidepressant toxicity Ann Emerg Med 26 1995 195 201
24. T.R. Wolfe, E.M. Caravati, and D.E. Rollins Terminal 40-ms frontal plane QRS axis as a marker for tricyclic antidepressant overdose Ann Emerg Med 18 4 1989 348 351
25. M. Berkovitch, D. Matsui, and R. Fogelman Assessment of the terminal 40-millisecond QRS vector in children with a history of tricyclic antidepressant ingestion Pediatr Emerg Care 11 2 1995 75 77
26. G.W. Kerr, A.C. McGuffie, and S. Wilkie Tricyclic antidepressant overdose: a review Emerg Med J 18 4 2001 236 241
27. L.D. Wilson, and C. Shelat Electrophysiologic and hemodynamic effects of sodium bicarbonate in a canine model of severe cocaine intoxication J Toxicol Clin Toxicol 41 6 2003 777 788
28. A.N. Sharma, A.H. Hexdall, and E.K. Chang Diphenhydramine-induced wide complex dysrhythmia responds to treatment with sodium bicarbonate Am J Emerg Med 21 3 2003 212 215
29. E. Bou-Abboud, and S. Nattel Relative role of alkalosis and sodium ions in reversal of class I antiarrhythmic drug-induced sodium channel blockade by sodium bicarbonate Circulation 94 8 1996 1954 1961
30. K.J. Beckman, R.B. Parker, and R.J. Hariman Hemodynamic and electrophysiological actions of cocaine. Effects of sodium bicarbonate as an antidote in dogs Circulation 83 5 1991 1799 1807
31. P.E. McKinney, and R. Rasmussen Reversal of severe tricyclic antidepressant-induced cardiotoxicity with intravenous hypertonic saline solution Ann Emerg Med 42 1 2003 20 24
32. J.L. McCabe, D.J. Cobaugh, and J.J. Menegazzi Experimental tricyclic antidepressant toxicity: a randomized, controlled comparison of hypertonic saline solution, sodium bicarbonate, and hyperventilation Ann Emerg Med 32 3 Pt 1 1998 329 333
33. J.R. Hoffman, S.R. Votey, and M. Bayer Effect of hypertonic sodium bicarbonate in the treatment of moderate-to-severe cyclic antidepressant overdose Am J Emerg Med 11 4 1993 336 341
34. A. Hoegholm, and P. Clementsen Hypertonic sodium chloride in severe antidepressant overdosage J Toxicol Clin Toxicol 29 2 1991 297 298
35. M. Eddleston, C.A. Ariaratnam, and L. Sjostrom Acute yellow oleander (Thevetia peruviana) poisoning: cardiac arrhythmias, electrolyte disturbances, and serum cardiac glycoside concentrations on presentation to hospital Heart 83 3 2000 301 306
36. Deaths associated with a purported aphrodisiac - New York City, February 1993-May 1995 MMWR Morb Mortal Wkly Rep 44 46 1995 853 855 861
37. R.M. Gowda, R.A. Cohen, and I.A. Khan Toad venom poisoning: resemblance to digoxin toxicity and therapeutic implications Heart 89 4 2003 e14
38. A. Gupta, P. Joshi, and S.A. Jortani A case of nondigitalis cardiac glycoside toxicity Ther Drug Monit 19 6 1997 711 714
39. G. Maringhini, L. Notaro, and O. Barberi Cardiovascular glycoside-like intoxication following ingestion of Thevetia nereifolia/peruviana seeds: a case report Ital Heart J 3 2 2002 137 140
40. M.E. Scheinost Digoxin toxicity in a 26-year-old woman taking an herbal dietary supplement J Am Osteopath Assoc 101 8 2001 444 446
41. J. Irwin Intensive care medicine M. Kirk B. Judge Digitalis poisoning 5th edition 2003 Lippincott Williams & Wilkins Baltimore
42. G. Ma, W.J. Brady, and M. Pollack Electrocardiographic manifestations: digitalis toxicity J Emerg Med 20 2 2001 145 152
43. J.Y. Chen, P.Y. Liu, and J.H. Chen Safety of transvenous temporary cardiac pacing in patients with accidental digoxin overdose and symptomatic bradycardia Cardiology 102 3 2004 152 155
44. R.A. Harrigan, A.D. Perron, and W.J. Brady Atrioventricular dissociation Am J Emerg Med 19 3 2001 218 222
45. W. Behringer, F. Sterz, and H. Domanovits Percutaneous cardiopulmonary bypass for therapy resistant cardiac arrest from digoxin overdose Resuscitation 37 1 1998 47 50
46. W.C. Lien, C.H. Huang, and W.J. Chen Bidirectional ventricular tachycardia resulting from digoxin and amiodarone treatment of rapid atrial fibrillation Am J Emerg Med 22 3 2004 235 236
47. A.D. Woolf, T. Wenger, and T.W. Smith The use of digoxin-specific Fab fragments for severe digitalis intoxication in children N Engl J Med 326 26 1992 1739 1744
48. J. Kaplanski, E. Weinhouse, and O. Martin Modification of digoxin induced arrhythmogenicity in adult rats following atropine administration Res Commun Chem Pathol Pharmacol 39 1 1983 173 176
49. R.O. Cummins, J. Haulman, and L. Quan Near-fatal yew berry intoxication treated with external cardiac pacing and digoxin-specific FAB antibody fragments Ann Emerg Med 19 1 1990 38 43
50. A. Mordel, H. Halkin, and L. Zulty Quinidine enhances digitalis toxicity at therapeutic serum digoxin levels Clin Pharmacol Ther 53 4 1993 457 462
51. T.L. Litovitz, W. Klein-Schwartz, and G.C. Rodgers Jr. 2001 annual report of the American Association of Poison Control Centers Toxic Exposure Surveillance System Am J Emerg Med 20 5 2002 391 452
52. Goldfrank L Goldfrank's toxicologic emergencies F. DeRoos Calcium channel blockers 7th edition 2002 McGraw-Hill New York
53. C. Holstege, M. Kirk, and R. Furbee Wide complex dysrhythmia in calcium channel blocker overdose responsive to sodium bicarbonate therapy [abstract] J Toxicol Clin Toxicol 36 5 1998 509
54. D.A. Tanen, A.M. Ruha, and S.C. Curry Hypertonic sodium bicarbonate is effective in the acute management of verapamil toxicity in a swine model Ann Emerg Med 36 6 2000 547 553
55. S. Sami-Karti, H. Ulusoy, and M. Yandi Non-cardiogenic pulmonary oedema in the course of verapamil intoxication Emerg Med J 19 5 2002 458 459
56. J.A. Kline, C.A. Tomaszewski, and J.D. Schroeder Insulin is a superior antidote for cardiovascular toxicity induced by verapamil in the anesthetized canine J Pharmacol Exp Ther 267 2 1993 744 750
57. J.A. Kline, E. Leonova, and R.M. Raymond Beneficial myocardial metabolic effects of insulin during verapamil toxicity in the anesthetized canine Crit Care Med 23 7 1995 1251 1263
58. J.N. Love, J.M. Howell, and J.T. Newsome The effect of sodium bicarbonate on propranolol-induced cardiovascular toxicity in a canine model J Toxicol Clin Toxicol 38 4 2000 421 428
59. K.D. Donovan, R.V. Gerace, and J.F. Dreyer Acebutolol-induced ventricular tachycardia reversed with sodium bicarbonate J Toxicol Clin Toxicol 37 4 1999 481 484
60. C.P. Snook, K. Sigvaldason, and J. Kristinsson Severe atenolol and diltiazem overdose J Toxicol Clin Toxicol 38 6 2000 661 665
61. J.N. Love, B. Enlow, and J.M. Howell Electrocardiographic changes associated with beta-blocker toxicity Ann Emerg Med 40 6 2002 603 610
62. D.M. Reith, A.H. Dawson, and D. Epid Relative toxicity of beta blockers in overdose J Toxicol Clin Toxicol 34 3 1996 273 278
63. A. Buiumsohn, E.S. Eisenberg, and H. Jacob Seizures and intraventricular conduction defect in propranolol poisoning. A report of two cases Ann Intern Med 91 6 1979 860 862
64. P.J. Neuvonen, E. Elonen, and L. Tarssanen Sotalol intoxication, two patients with concentration-effect relationships Acta Pharmacol Toxicol (Copenh) 45 1 1979 52 57
65. B. Sangster, D. de Wildt, and A. van Dijk A case of acebutolol intoxication J Toxicol Clin Toxicol 20 1 1983 69 77
66. R.R. Long, J.C. Sargent, and K. Hammer Paralytic shellfish poisoning: a case report and serial electrophysiologic observations Neurology 40 8 1990 1310 1312
67. L. Goldfrank Goldfrank's toxicologic emergencies J. Brubacher Beta-adrenergic blockers 7th edition 2002 McGraw-Hill New York
68. J.N. Love, D. Hanfling, and J.M. Howell Hemodynamic effects of calcium chloride in a canine model of acute propranolol intoxication Ann Emerg Med 28 1 1996 1 6
69. W. Kearns, D. Schroeder, and C. Williams Insulin improves survival in a canine model of acute beta-blocker toxicity Ann Emerg Med 29 6 1997 748 757