Comparison of the therapeutic effect between sodium bicarbonate and insulin on acute propafenone toxicity

Yi, Hankuil; Lee, Jang Young; Lee, Won Suk; Sung, Won Young; Seo, Sang Won

doi:10.1016/j.ajem.2014.07.010

Cited by 8 publications

(4 citation statements)

References 14 publications

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“…In a report of a previous case, we stated that insulin‐dextrose treatment may be effective for propafenone intoxication . This was confirmed with animal experiments . However, in this case we chose ILE, partly because ILE has been used effectively for local anesthetic and antiarrhythmic toxicity, as well as multiple medication intakes .…”

Section: Discussionmentioning

confidence: 81%

“…4 This was confirmed with animal experiments. 16,17 However, in this case we chose ILE, partly because ILE has been used effectively for local anesthetic and antiarrhythmic toxicity, as well as multiple medication intakes. 12 In recent experience in our emergency department, ILE has been successfully applied for intoxication cases resistant to other treatments.…”

Section: Discussionmentioning

confidence: 99%

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Successful Treatment of Propafenone Intoxication With Intravenous Lipid Emulsion

et al. 2015

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Severe cardiac effects, including cardiac arrest, are a rare complication of high-dose propafenone intake. Among patients who experience cardiac arrest, the survival rate is low. This report presents the case of a young female patient who developed cardiac arrest linked to propafenone intake. While spontaneous circulation was restored with cardiopulmonary resuscitation, vital signs did not recover despite supportive treatment. However, after the administration of intravenous lipid emulsion (ILE), vital signs and cardiac functions resolved and the patient survived. This case is the second to describe the successful use of ILE for propafenone intoxication. However, as all of the findings of this patient were clearly linked to propafenone, we believe the benefits of ILE were more clearly defined in this case than in the other.

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Section: Discussionmentioning

confidence: 81%

Section: Discussionmentioning

confidence: 99%

Successful Treatment of Propafenone Intoxication With Intravenous Lipid Emulsion

et al. 2015

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“…Theoretically, sodium bicarbonate is effective in sodium channel blocking agent toxicity, but in a study with class 1C antiarrhythmics, bicarbonate alone was not effective in reversing ECG effects at therapeutic doses 7 . Again, in an animal research study comparing the efficacy of insulin and sodium bicarbonate therapy in acute propafenone toxicity, insulin therapy was found to be more effective 8 . In our case, sodium bicarbonate and lipid emulsion treatment was not applied due to the resolution of cardiotoxic arrhythmia in a very short time after her admission, and metabolic acidemia was observed to regress with supportive treatment.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous Resolution Of Arrhythmia in Propafenone Intoxication: A Rare Case Report

YILMAZ¹,

SATICI²,

İslam³

et al. 2022

Eurasian Journal of Toxicology

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Propafenone toxicity is rare but poses a life-threatening condition due to malignant arrhythmias. However, there is currently no recommended standard specific treatment or antidote. In our case, we presented a young patient with transient cardiac toxicity and spontaneous recovery in her follow up after taking high-dose propafenone for suicide attempt. Electrocardiography showed sinus rhythm with prolongation of PR interval with 240 ms, QRS width 160 ms, and corrected QT interval QTc with 498 ms; Terminal R wave observed in leads V1 and aVR and metabolic acidosis was also observed at the time of admission. In patient's follow up, sodium bicarbonate and lipid emulsion treatment was planned but did not applied due to the resolution of cardiotoxic arrhythmia in 30 minutes after her admission, and metabolic acidemia was observed to regress with supportive treatment. In conclusion, propofenone intoxication, like other class 1C antiarrhythmics, is a life-threatening, rarely reported toxicity that complicates clinical decisions. It is critical to be aware that propofenone overdose can be fatal, and is also essential to remember that, despite the lack of an antidote, total recovery can be accomplished with constant monitoring and supportive treatment.

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“…The use of high doses of insulin and glucose may reduce mortality but experimental and clinical studies should be conducted to evaluate the effectiveness of this treatment method in cases of Propafenone overdose [6]. Treatment with insulin and NaHCO3 in a study of these substances in rats increased survival, but insulin was more effective, so treatment with glucose and insulin infusion should be considered for the treatment of acute Propafenone cardiotoxicity that does not respond to current therapies [7].…”

Section: Discussionmentioning

confidence: 99%

Suicide attempt of young woman by Propafenone overdose - case report

Wais,

Gruca,

Zając

2023

J Educ Health Sport

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Introduction and purpose: Over the last few years, the number of suicide attempts in Polish women has been steadily increasing. This report presents a case of a 18 years old woman hospitalized in the Toxicology and Cardiology Department due to poisoning with antiarrhythmic drug – Propafenone, taken for suicide purpose. Brief description of the state of knowledge: Propafenone is an antiarrhythmic drug which belongs to class IC according to the Vaughan-Williams classification. The overdose of this drug can cause various symptoms and complications such as cardiac arrhythmias, liver damage, cardiac arrest and even death. This drug has no specific antidote. Conclusions: Propafenone poisoning is a significant clinical challenge and the consequences are often unpredictable and life-threatening. Treatment options such as natrium bicarbonicum, insulin, intravenous lipid emulsion, calcium gluconate seem to be good choices and the effects of treatment with these drugs are promising for the future.

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Comparison of the therapeutic effect between sodium bicarbonate and insulin on acute propafenone toxicity

Cited by 8 publications

References 14 publications

Successful Treatment of Propafenone Intoxication With Intravenous Lipid Emulsion

Successful Treatment of Propafenone Intoxication With Intravenous Lipid Emulsion

Spontaneous Resolution Of Arrhythmia in Propafenone Intoxication: A Rare Case Report

Suicide attempt of young woman by Propafenone overdose - case report

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