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10.1007/BF03160963 http://scihub22266oqcxt.onion/10.1007/BF03160963 18570170!3550142!18570170     free     free     free Deprecated: Implicit conversion from float 213.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 213.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 213.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 213.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 213.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534       J+Med+Toxicol 2008 ; 4 (2): 101-5 Nephropedia Template TP {{tp|p=18570170|t=2008. Citalopram overdose: late presentation of torsades de pointes (TdP) with cardiac arrest |pdf=|usr=}}{{18570170}} gab.com Text Citalopram overdose: late presentation of torsades de pointes (TdP) with cardiac arrest JO: J Med Toxicol http://www.kidney.de/pget.php?&tw=1&pmid=18570170 #FOAvip INTRODUCTION: Citalopram overdose may produce bradycardia, QT prolongation, and torsades de pointes (TdP). A cardiotoxic metabolite may be responsible for the delayed onset of cardiotoxicity. Although some authorities recommend a minimum of 24 hours of observation following citalopram overdose, a recent analysis suggested that dysrhythmias rarely occur beyond 13 hours post-ingestion. We present a case of citalopram overdose with a substantially delayed onset of cardiac toxicity. CASE REPORT: A 36-year-old woman complained of shakiness, numbness in the arms, and palpitations that began approximately 32 hours after ingesting 50 (20-mg) tablets of citalopram. Her initial vital signs were: blood pressure, 84/44 mmHg; pulse, 102-150/minute; respirations, 17/min; temperature, 99.3 degrees F (37.3 degrees C). Her initial ECG showed sinus rhythm with a prolonged corrected QT interval (572 msec) with paroxysmal, self-limited runs of wide-complex tachycardia that appeared multifocal in nature. Approximately 20 minutes after presentation, she experienced self-terminating TdP, with transient hypotension and loss of consciousness. Her serum citalopram concentration (33 hours post-ingestion) was 477 ng/mL (therapeutic: 40-110 ng/mL); desmethylcitalopram concentration was 123.2 ng/mL (therapeutic: 14-40 ng/mL). She was treated with magnesium and lidocaine, and her corrected QT interval remained abnormal for 24 hours after presentation. DISCUSSION: Citalopram overdose can produce life-threatening cardiac toxicity with a clinical onset that may be delayed beyond a routine observation period of 6 hours. Once the QT interval is prolonged, it seems prudent to prolong the observation period. Twit Text FOAVip Citalopram overdose: late presentation of torsades de pointes (TdP) with cardiac arrest ????J Med Toxicol http://www.kidney.de/pget.php?&tw=1&pmid=18570170 #FOAvip Twit Text # Free Paper on # # # # # LINK http://www.kidney.de/pget.php?&tw=1&pmid=18570170 #FOAvip English Wikipedia <ref>{{Cite pmid|18570170}}</ref> Citalopram overdose: late presentation of torsades de pointes (TdP) with cardiac arrest #MMPMID18570170 Tarabar AF; Hoffman RS; Nelson L J Med Toxicol 2008[Jun]; 4 (2): 101-5 PMID18570170show ga INTRODUCTION: Citalopram overdose may produce bradycardia, QT prolongation, and torsades de pointes (TdP). A cardiotoxic metabolite may be responsible for the delayed onset of cardiotoxicity. Although some authorities recommend a minimum of 24 hours of observation following citalopram overdose, a recent analysis suggested that dysrhythmias rarely occur beyond 13 hours post-ingestion. We present a case of citalopram overdose with a substantially delayed onset of cardiac toxicity. CASE REPORT: A 36-year-old woman complained of shakiness, numbness in the arms, and palpitations that began approximately 32 hours after ingesting 50 (20-mg) tablets of citalopram. Her initial vital signs were: blood pressure, 84/44 mmHg; pulse, 102-150/minute; respirations, 17/min; temperature, 99.3 degrees F (37.3 degrees C). Her initial ECG showed sinus rhythm with a prolonged corrected QT interval (572 msec) with paroxysmal, self-limited runs of wide-complex tachycardia that appeared multifocal in nature. Approximately 20 minutes after presentation, she experienced self-terminating TdP, with transient hypotension and loss of consciousness. Her serum citalopram concentration (33 hours post-ingestion) was 477 ng/mL (therapeutic: 40-110 ng/mL); desmethylcitalopram concentration was 123.2 ng/mL (therapeutic: 14-40 ng/mL). She was treated with magnesium and lidocaine, and her corrected QT interval remained abnormal for 24 hours after presentation. DISCUSSION: Citalopram overdose can produce life-threatening cardiac toxicity with a clinical onset that may be delayed beyond a routine observation period of 6 hours. Once the QT interval is prolonged, it seems prudent to prolong the observation period. |Adult[MESH] |Anti-Arrhythmia Agents/therapeutic use[MESH] |Antidepressive Agents, Second-Generation/blood/*poisoning[MESH] |Citalopram/blood/*poisoning[MESH] |Drug Overdose[MESH] |Electrocardiography[MESH] |Female[MESH] |Heart Arrest/*chemically induced/drug therapy/physiopathology[MESH] |Humans[MESH] |Lidocaine/therapeutic use[MESH] |Magnesium Sulfate/therapeutic use[MESH] |Selective Serotonin Reuptake Inhibitors/blood/*poisoning[MESH] |Suicide, Attempted[MESH] |Time Factors[MESH] |Torsades de Pointes/*chemically induced/drug therapy/physiopathology[MESH]Citalopram overdose: late presentation of torsades de pointes (TdP) wi(epmc).pdf DeepDyve Pubget Overpricing