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Cardiotoxic effects of astemizole overdose in children
J F Wiley1, M L Gelber, F M Henretig
1Section of General Pediatrics, St. Christopher's Hospital for Children, Philadelphia, Pennsylvania.
Insights
Astemizole overdose in children can cause serious heart problems like dangerous rhythms and heart block. Affected children require immediate medical care and cardiac monitoring.
Area of Science:
- Cardiology
- Pediatric Toxicology
Background:
- Astemizole is a widely used nonsedating antihistamine.
- Antihistamines are generally considered safe, but overdose effects require investigation.
Observation:
- Five children experienced cardiotoxicity after astemizole overdose.
- Observed effects included prolonged corrected QT interval and ventricular dysrhythmias.
- Atrioventricular heart block was also noted in affected children.
Findings:
- Cardiotoxic effects persisted for an average of 2.5 days.
- The severity of cardiac events necessitates prompt medical intervention.
Implications:
- Children with suspected astemizole poisoning require urgent evaluation.
- Electrocardiogram monitoring, including corrected QT interval calculation, is crucial.
- Continuous cardiac monitoring for 24 hours is recommended for pediatric patients.
Abstract:
Astemizole, a nonsedating antihistamine, caused a prolonged corrected QT interval, ventricular dysrhythmias, and atrioventricular heart block after overdose in five children. Cardiotoxic effects lasted an average of 2 1/2 days. Children poisoned with astemizole need emergent medical evaluation, a 12-lead electrocardiogram with calculation of the corrected QT interval, and continuous cardiac monitoring for 24 hours.