Lacosamide-induced sinus node dysfunction followed by severe agranulocytosis.
Makoto Shibata1, Reona Hoshino1, Chisato Shimizu1
1Department of Neurology, Takasaki General Medical Center, National Hospital Organization, 36 Takamatsu-cho, Takasaki, 370-0829, Gunma, Japan.
Lacosamide (LCM), an antiepileptic drug, can cause severe sinus node dysfunction (SND) and agranulocytosis. This case highlights the risk of simultaneous adverse events during early LCM treatment, necessitating careful patient monitoring.
Area of Science:
- Pharmacology
- Neurology
- Cardiology
Background:
- Lacosamide (LCM) is an antiepileptic drug approved in 2008, known to modulate voltage-gated sodium channels.
- Adverse effects of LCM include neutropenia and cardiac events like sinus node dysfunction (SND) and atrioventricular block.
- Severe agranulocytosis and concomitant SND with agranulocytosis have not been previously reported with LCM.
Observation:
- A patient with focal epilepsy was treated with LCM, with dosage escalation from 100 mg/day to 200 mg/day.
- The patient developed severe SND on the 10th hospital day, leading to LCM discontinuation.
- Agranulocytosis emerged on the 11th hospital day, and the patient ultimately died from septic shock.
Findings:
- This report details the first case of severe LCM-induced SND followed by agranulocytosis.
- The adverse events occurred early in LCM treatment, even at low dosages and short duration.
- Simultaneous occurrence of multiple severe side effects from LCM is possible.
Implications:
- Close monitoring of electrocardiograms and complete blood cell counts is crucial when initiating LCM.
- Clinicians should be vigilant for the potential of simultaneous adverse effects during early LCM therapy.
- This case underscores the importance of prompt recognition and management of LCM-associated toxicities.
More Related Videos
10:41Laser-Induced Action Potential-Like Measurements of Cardiomyocytes on Microelectrode Arrays for Increased Predictivity of Safety Pharmacology
Published on: September 13, 2022
08:52Generation of Murine Cardiac Pacemaker Cell Aggregates Based on ES-Cell-Programming in Combination with Myh6-Promoter-Selection
Published on: February 17, 2015
Related Concept Videos
Antiarrhythmic Drugs: Class I Agents as Sodium Channel Blockers
Class 1A Antiarrhythmic Drugs: These drugs work by moderately blocking sodium channels,...
Antiepileptic Drugs: Potassium Channel Activators
Ezogabine has gained approval as an adjunctive treatment...
Antiarrhythmic Drugs: Class III Agents as Potassium Channel Blockers
Local Anesthetics: Adverse Effects
Once absorbed into the systemic circulation, local anesthetics can affect the organs that depend on the functioning of sodium...
Antiepileptic Drugs: Sodium Channel Blockers
Sodium channel blockers modulate ion channels, particularly voltage-gated sodium channels. They block only sodium ion movement.
Among the most commonly prescribed antiepileptic drugs are...
Antiarrhythmic Drugs: Class IV Agents as Calcium Channel Blockers
Verapamil, a calcium channel blocker, inhibits calcium movement across myocardial cell membranes and vascular smooth muscle. This results in the dilation of coronary and...
