Amiodarone-induced hyperthyroidism: Thyroidectomy under local anesthesia
1991; Elsevier BV; Volume: 122; Issue: 4 Linguagem: Inglês
10.1016/0002-8703(91)90488-4
ISSN1097-6744
AutoresAnilkumar Mehra, Josef Widerhorn, Jonathan S. LoPresti, Shahbudin H. Rahimtoola,
Tópico(s)Takotsubo Cardiomyopathy and Associated Phenomena
ResumoThis chapter discusses positive inotropic drugs and drugs used in dysrhythmias. Accidental administration of digoxin intrathecally has been reported in three cases in which ampoules containing digoxin were thought to have been confused with ampoules containing lidocaine, because they looked alike. In one case, paresthesia and paralysis of the lower limbs occurred up to the umbilical level; the patient, a 21-year-old man, was conscious but agitated, tachycardic, and hypertensive, with abdominal distension, urinary retention, and absent leg reflexes. Studies show that digoxin-specific antibody Fab fragments are effective in the management of digitalis intoxication. However, in patients with severe renal impairment the clearance of antibody–digoxin complexes is reduced, and rebound toxicity can occur if the cardiac glycoside dissociates from the antibody. Phosphodiesterase inhibitors, such as milrinone, can cause hypotension due to vasodilatation, necessitating the use of vasoconstrictors. Flecainide has been found to cause ventricular dysrhythmias in patients with structural cardiac abnormalities, but dysrhythmias can occasionally occur in patients with normal cardiac structure.
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