ABSTRACT
Some factors have been identified as contributing to medical errors such as labels, appearance, and location of ampules. In this case report, inadvertent intrathecal injection of 80 mg tranexamic acid was followed by severe pain in the back and the gluteal region, myoclonus on lower extremities and agitation. General anesthesia was induced to complete surgery. At the end of anesthesia, patient developed polymyoclonus and seizures needing supportive care of the hemodynamic, and respiratory systems. He developed ventricular tachycardia treated with Cordarone infusion. The patient's condition progressively improved to full recovery 2 days after. Confusion between hyperbaric bupivacaine and tranexamic acid was due to similarities in appearance between both ampules
Subject(s)
Humans , Male , Ventricular Fibrillation/chemically induced , Injections, Spinal/adverse effects , Fatal Outcome , Medical Errors , Drug Labeling/standardsABSTRACT
Tranexamic acid is generally used in the treatment of disorders that predispose one to bleeding. It is a synthetic lysine analog that has strong antifibrinolytic activity. Plasminogen binds to fibrin to form plasmin, which in turn degrades fibrin into fibrin degradation products. Tranexamic acid blocks the lysine binding site on plasminogen and prevents interaction with fibrin. Tranexamic acid reduces blood loss in open heart surgery, hip replacement, and gynecology procedures. In this first case of inadvertent intrathecal injection of Tranexamic acid in a pregnant woman, we found that a massive intrathecal injection of Tranexamic acid triggered refractory ventricular fibrillation and cardiovascular collapse, which did not respond to full resuscitation
Subject(s)
Humans , Female , Ventricular Fibrillation/chemically induced , Myoclonus/chemically induced , Seizures/chemically induced , Medication Errors , Antifibrinolytic Agents/administration & dosage , Injections, Spinal , Pregnant Women , Anesthesia, Endotracheal/adverse effectsABSTRACT
The use of adenosine has been suggested as a diagnostic tool in the evaluation of wide ORS complex tachycardia. However, adenosine shortens the antegrade refractoriness of accessory atrioventricular connections and may cause acceleration of the ventricular rate during atrial fibrillation. We observed ventricular fibrillation in 2 patients who presented to the emergency department with pre-excited atrial fibrillation and were given 12 mg of adenosine.
Subject(s)
Adenosine/adverse effects , Adult , Anti-Arrhythmia Agents/adverse effects , Electric Countershock , Electrocardiography , Emergency Service, Hospital , Follow-Up Studies , Humans , Infusions, Intravenous , Male , Risk Assessment , Tachycardia, Supraventricular/diagnosis , Ventricular Fibrillation/chemically inducedSubject(s)
Aconitum/poisoning , Electrocardiography , Humans , Male , Middle Aged , Ventricular Fibrillation/chemically inducedABSTRACT
Two cases with severe hypoglycaemia following zinc phosphide poisoning are reported. Both patients succumbed to toxic myocarditis.
Subject(s)
Adult , Humans , Hypoglycemia/chemically induced , Male , Drug Overdose/complications , Phosphines/poisoning , Rodenticides , Suicide , Ventricular Fibrillation/chemically induced , Zinc/poisoning , Zinc CompoundsSubject(s)
Adult , Female , Heart Arrest/chemically induced , Humans , India , Plant Extracts/poisoning , Trees , Ventricular Fibrillation/chemically inducedABSTRACT
The effects of a new series of glutarimide compounds have been studied in acetylcholine induced auricular fibrillation in anaesthetized cats and epinephrine induced ventricular arrhythmmias in conscious pigeons. Some of the compounds showed varying degree of protective action against experimental arrhythmias. However these compounds were found to be less potent than quinidine. The mechanism of antiarrhythmic action has been discussed.