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Management of life-threatening flecainide overdose: a case report of an infant

Published online by Cambridge University Press:  17 May 2021

T. Tuncer*
Affiliation:
Department of Pediatrics, Division of Pediatric Cardiology, Saglik Bilimleri University, Prof. Dr. Ilhan Varank Training and Research Hospital, Istanbul, Turkey
*
Author for correspondence: T. Tuncer, M.D., Department of Pediatrics, Division of Pediatric Cardiology, Saglik Bilimleri University, Prof. Dr. Ilhan Varank Training and Research Hospital, Istanbul, Turkey. Tel: +90-505-8311611. E-mail: [email protected]

Abstract

Flecainide overdose is associated with an approximately 10% mortality rate. The drug’s slow rate of elimination and high oral bioavailability make successful management extremely challenging. I present the management of a life-threatening flecainide overdose of an infant who had a protracted course due to the exposure to the drug in both the fetal and neonatal periods.

Type
Brief Report
Copyright
© The Author(s), 2021. Published by Cambridge University Press

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References

Cheung, I, Man, C. Review on flecainide poisoning. Hong Kong J Emerg Med. 2002; 9: 150153. doi: 10.1177/102490790200900306.CrossRefGoogle Scholar
Devin, R, Garrett, P, Anstey, C. Managing cardiovascular collapse in severe flecainide overdose without recourse to extracorporeal therapy. Emerg Med Australas 2007; 19: 155159. doi: 10.1111/j.1742-6723.2006.00909.x.Google ScholarPubMed
Gotz, D, Pohle, S, Barckow, D. Primary and secondary detoxification in severe flecainide intoxication. Intensive Care Med 1991; 17: 181184. doi: 10.1007/BF01704725.CrossRefGoogle ScholarPubMed
Roden, DM, Woosley, RL Drug therapy. Flecainide. N Engl J Med 1986; 315: 3641. doi: 10.1056/NEJM198607033150106.CrossRefGoogle ScholarPubMed
Koppel, C, Oberdisse, U, Heinemeyer, G. Clinical course and outcome in class IC antiarrhythmic overdose. J Toxicol Clin Toxicol 1990; 28: 433444. doi: 10.3109/15563659009038586.CrossRefGoogle ScholarPubMed
Karmegaraj, B, Menon, D, Prabhu, MA, Vaidyanathan, B. Flecainide toxicity in a preterm neonate with permanent junctional reciprocating tachycardia. Ann Pediatr Card 2017; 10: 28892. doi: 10.4103/apc.APC_31_17.Google Scholar
Bhimani, Salima Ahmed, Rao, Sruti, Nadorlik, Holly, Saarel, Elizabeth V, Aziz, Peter F. Flecainide toxicity in renal tubular acidosis type IV treated with extracorporeal membrane oxygenation. HeartRhythm Case Rep. 2020; 6: 287289. doi: 10.1016/j.hrcr.2020.02.001.CrossRefGoogle ScholarPubMed
Jang, David H, Hoffman, Robert S, Nelson, Lewis S. A case of near-fatal flecainide overdose in a neonate successfully treated with sodium bicarbonate. J Emerg Med 2013; 44: 781783. doi: 10.1016/j.jemermed.2012.07.050.CrossRefGoogle Scholar
Salerno, DM, Murakami, MM, Johnston, RB, et al. Reversal of flecainide-lnduced ventricular arrhythmia by hypertonic sodium bicarbonate in dogs. Am J Emerg Med 1995; 13: 285293. doi: 10.1016/0735-6757(95)90201-5.CrossRefGoogle ScholarPubMed