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Related Concept Videos

Pharmaceutical Poisoning: Treatment Strategies01:26

Pharmaceutical Poisoning: Treatment Strategies

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Treatment strategies for poisoning are a critical aspect of emergency medicine, focusing on preventing the absorption of toxins and enhancing their elimination. When a poisoning incident occurs, the first response is to halt exposure and decontaminate the patient, particularly through gastrointestinal (GI) methods if the poison was ingested.Gastrointestinal Decontamination Techniques:Activated charcoal is the cornerstone of GI decontamination. It works through adsorption, binding the toxin to...
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Pharmaceutical Poisoning: Potential Scenarios01:26

Pharmaceutical Poisoning: Potential Scenarios

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Pharmaceutical poisoning can occur through various channels, impacting an estimated 2 million hospitalized patients in the U.S. annually with serious adverse drug responses. These scenarios encompass both therapeutic uses, such as drug toxicity, where even standard dosages can lead to severe central nervous system depression, and non-therapeutic exposures, including accidental ingestion by children, and environmental and occupational exposures.Unintentional poisonings often involve exploratory...
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Drug Toxicity: Risk factors01:24

Drug Toxicity: Risk factors

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Adverse Drug Reactions (ADRs) are potential complications that arise during pharmacotherapy, influenced by multiple risk factors. Age plays a significant role; both neonates and the elderly are at heightened risk due to their respective immature and diminished metabolic and elimination processes. Gender also impacts ADRs, with females experiencing a 1.5 to 1.7-fold greater risk than males, which may be linked to pharmacokinetic, pharmacodynamic, and hormonal differences. Notably, neonates, the...
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Drug Toxicity: Dose-Dependent Reactions01:24

Drug Toxicity: Dose-Dependent Reactions

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Drug toxicities can be stratified into pharmacological, pathological, or genotoxic based on their mechanisms. The incidence and severity of these toxicities generally increase with the drug's concentration in the body and exposure time.Pharmacological toxicity is evident when the therapeutic effects of drugs overshoot into adverse reactions in a predictable, dose-dependent manner. Central nervous system (CNS) depression from barbiturates is a classic example, with effects escalating from...
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Drug Toxicity: Overview01:00

Drug Toxicity: Overview

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Drug toxicity quantifies the harm a compound causes to an organism, varying by dose and potentially impacting whole systems or specific organs like the liver. Toxic reactions may arise from venomous insect or spider bites, with effects ranging from mild symptoms to severe outcomes such as brain damage or death. Common forms of acute poisoning include ethanol intoxication and overdose of pain or fever medications, with substances like GHB and heroin being particularly lethal at doses close to...
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Anticholinesterase Agents: Poisoning and Treatment01:26

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Anticholinesterases, also known as cholinesterase inhibitors, work by blocking the breakdown of acetylcholine, leading to its accumulation in the synaptic cleft. This accumulation indirectly enhances both muscarinic and nicotinic actions. These agents are classified as reversible or irreversible based on their mechanism of action.     
Irreversible agents form a strong bond with the cholinesterase enzyme, making it inactive. The breakdown of the phosphorylated enzyme is...
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Related Experiment Video

Updated: Mar 15, 2026

Laser-Induced Action Potential-Like Measurements of Cardiomyocytes on Microelectrode Arrays for Increased Predictivity of Safety Pharmacology
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Dofetilide in Overdose: A Case Series from Poison Center Data.

M A Hieger1,2,3, K F Maskell4,5,6, M J Moss6

  • 1Division of Clinical Toxicology, Department of Emergency Medicine, VCU Medical Center, 1250 E. Marshall Street, 2nd Floor, Richmond, VA, 23298, USA. michellehieger@gmail.com.

Cardiovascular Toxicology
|August 28, 2016
PubMed
Summary

Small dofetilide overdoses often cause no significant effects and can be managed at home. Large intentional overdoses, however, may lead to serious cardiac events requiring medical intervention.

Keywords:
AntiarrhythmicDofetilideDysrhythmiaOverdosePoison centerQTc prolongationTikosynTorsadesVentricular tachycardia

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Area of Science:

  • Cardiology
  • Clinical Toxicology

Background:

  • Dofetilide is a Class III antiarrhythmic medication for atrial dysrhythmias.
  • Adverse effects of dofetilide are known, but its toxicity in overdose is not well-documented.

Purpose of the Study:

  • To describe the clinical effects and management of dofetilide overdose.

Main Methods:

  • Retrospective case series of patients reported to a poison center for dofetilide overdose.
  • Included 27 cases with varying overdose amounts and co-ingestants.

Main Results:

  • Most patients (21/27) took only one extra capsule and experienced no significant clinical effects.
  • One patient with a large intentional overdose (90x usual dose) developed non-sustained ventricular tachycardia and PVCs.
  • No patients required cardioversion, defibrillation, CPR, or overdrive pacing.

Conclusions:

  • Unintentional, small dofetilide overdoses may not cause significant clinical toxicity and can often be managed outside a healthcare facility.
  • Large intentional overdoses pose a risk for significant cardiac events.