Sudden Cardiac Arrest in a Patient on Chronic Methadone After the Addition of Azithromycin

Abstract Corrected QT-interval (QTc) prolongation with increased risk of fatal arrhythmia is a well-established toxicity of methadone. In this study, a case of sudden cardiac arrest in a patient on chronic methadone therapy is presented. A 47-year-old man presented unresponsive to the emergency depa...

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Bibliographic Details
Published in:The American journal of the medical sciences 2013-02, Vol.345 (2), p.160-162
Main Authors: Winton, John C., MD, Twilla, Jennifer D., PharmD
Format: Article
Language:English
Subjects:
Arrhythmia
Azithromycin
Azithromycin - administration & dosage
Azithromycin - adverse effects
Death, Sudden, Cardiac - etiology
Drug Therapy, Combination
Heart Arrest - chemically induced
Heart Arrest - diagnosis
Humans
Internal Medicine
Male
Methadone
Methadone - administration & dosage
Methadone - adverse effects
Middle Aged
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Summary:Abstract Corrected QT-interval (QTc) prolongation with increased risk of fatal arrhythmia is a well-established toxicity of methadone. In this study, a case of sudden cardiac arrest in a patient on chronic methadone therapy is presented. A 47-year-old man presented unresponsive to the emergency department after pulseless arrest at his home. The patient’s wife revealed he was taking methadone as part of an ongoing opioid dependency treatment and that he was prescribed azithromycin for an upper respiratory tract infection 3 days before his presentation. A 12-lead electrocardiogram at the time of presentation showed sinus tachycardia and a QTc of 490 milliseconds. It was concluded that the patient experienced a fatal arrhythmia because of QTc prolongation, precipitated by azithromycin in the setting of ongoing methadone use.
ISSN:0002-9629
1538-2990
DOI:10.1097/MAJ.0b013e318266e7af