Reactions 1704, p326 - 2 Jun 2018 Sinus bradycardia and congestive heart failure: case report A 73-year-old woman developed sinus bradycardia and congestive heart failure (CHF) during treatment with propafenone for supraventricular tachycardia in a medication error [route and time to reactions onsets not stated]. The woman presented to the pharmacy department for collecting a prescription of propafenone 150mg every 12 hours (total daily dose: 300mg) for supraventricular tachycardia. She was receiving levothyroxine and omeprazole concomitantly for hypothyroidism and acid peptic disease, respectively. The hospital pharmacist did not consider propafenone for supraventricular tachycardia as adequate treatment, since it was known to precipitate heart failure in elderly patients. Hence, the pharmacist created a clinical alert for a safety drug related problem, wherein propafenone was to be dispensed as per the prescriber. Since the clinical alert was ignored, propafenone was dispensed at the prescribed dose. On the following day, she presented to the emergency service with general malaise, fatigue and weakness present since the previous day. She was hospitalised with hypotension, severe bradycardia and definite signs of heart failure. She was then diagnosed with sinus bradycardia and congestive heart failure secondary to propafenone use. The woman was treated with oxygen therapy and atropine. Her propafenone treatment was discontinued, and she started receiving treatment with metoprolol. Subsequently, she showed improvement and was discharged on the next day. Author comment: A diagnosis was made of sinus bradycardia and congestive heart failure secondary to the use of propafenone. However, the case indicates a problem with acceptance by the prescriber, considering that although the alert was generated, a fourth-line drug was dispensed with a clearly less favourable safety profile compared to other therapies (e.g. beta-blockers, calcium channel blockers). Calderon-Ospina CA, et al. Bradicardia desencadenada por propafenona. Pharmaceutical Care Espana 20: 72-77, No. 1, 2018. Available from: URL: http:// www.pharmcareesp.com/index.php/PharmaCARE/article/view/439 [Spanish; summarised from a translation] - Colombia 803323176 0114-9954/18/1704-0001/$14.95 Adis © 2018 Springer International Publishing AG. All rights reserved Reactions 2 Jun 2018 No. 1704
Reactions Weekly – Springer Journals
Published: Jun 2, 2018
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