Related Experiment Video

Updated: Sep 21, 2025

Improved Renal Denervation Mitigated Hypertension Induced by Angiotensin II Infusion
08:35

Improved Renal Denervation Mitigated Hypertension Induced by Angiotensin II Infusion

Published on: May 26, 2022

3.5K

Vandetanib-Induced Hyponatremia and Torsades De Pointes: A Case Report

Shoaib Ashraf1, Niel Shah1, Muhammad Saad2

  • 1Internal Medicine, BronxCare Health System/Icahn School of Medicine at Mount Sinai, New York City, USA.

Cureus
|June 2, 2022
PubMed

Insights

This case report details a patient with advanced medullary thyroid cancer (MTC) who experienced severe cardiac events, including Torsades de Pointes, while on Vandetanib. Discontinuation of Vandetanib resolved these dangerous arrhythmias.

Area of Science:

  • Endocrinology
  • Oncology
  • Cardiology

Background:

  • Medullary thyroid cancer (MTC) is a rare neuroendocrine tumor with a poor prognosis in advanced stages.
  • Vandetanib is approved for advanced MTC, demonstrating efficacy in prolonging progression-free survival.
  • Vandetanib carries risks of serious cardiovascular side effects, including QTc prolongation and arrhythmias.

Observation:

  • An 83-year-old female with metastatic MTC developed hyponatremia and QTc prolongation during Vandetanib treatment.
  • The patient experienced ventricular fibrillation and Torsades de Pointes (TdP), a life-threatening arrhythmia.
  • These adverse events occurred while on Vandetanib 300 mg/day.

Findings:

  • Discontinuation of Vandetanib therapy led to the resolution of Torsades de Pointes.
  • This case highlights a potential link between Vandetanib, hyponatremia, and severe cardiac arrhythmias.
  • This is the second reported case of Vandetanib-induced Torsades de Pointes in medullary thyroid cancer patients.

Implications:

  • Clinicians should closely monitor patients on Vandetanib for electrolyte imbalances and QTc prolongation.
  • Vigilance for cardiac arrhythmias like TdP is crucial in patients with advanced MTC treated with Vandetanib.
  • This case underscores the importance of risk-benefit assessment and careful patient selection for Vandetanib therapy.
Keywords:
hyponatremialong qt syndrometorsades de pointesvandetanibventricular tachycardia

More Related Videos

A Novel Approach for the Administration of Medications and Fluids in Emergency Scenarios and Settings06:59

A Novel Approach for the Administration of Medications and Fluids in Emergency Scenarios and Settings

Published on: November 9, 2016

30.6K
Early Detection of Drug-Induced Renal Hemodynamic Dysfunction Using Sonographic Technology in Rats06:38

Early Detection of Drug-Induced Renal Hemodynamic Dysfunction Using Sonographic Technology in Rats

Published on: March 11, 2016

12.2K

Related Concept Videos

Antihypertensive Drugs: Potassium-Sparing Diuretics01:28

Antihypertensive Drugs: Potassium-Sparing Diuretics

Liddle syndrome is a genetically inherited form of hypertension characterized by the overactivity of epithelial sodium channels in the nephron, the functional unit of the kidney. This heightened activity leads to increased sodium reabsorption and excessive excretion of potassium. To counteract this, potassium-sparing diuretics such as amiloride are used. They function by blocking these sodium channels, thereby reducing the influx of sodium into the epithelial cells and minimizing the loss of...
801
Antihypertensive Drugs: Thiazide-Class Diuretics01:15

Antihypertensive Drugs: Thiazide-Class Diuretics

Thiazide diuretics are sulfonamide derivatives featuring a benzothiadiazine ring system in their molecular structure. Based on this structure, thiazide diuretics can be categorized into two groups: thiazide-type and thiazide-like diuretics. Thiazide-type diuretics, including hydrochlorothiazide and chlorothiazide, consist of a benzothiadiazine backbone with an attached sulfonamide group. Thiazide-like diuretics, such as chlorthalidone and indapamide, lack the thiazide ring but demonstrate...
914
Antiarrhythmic Drugs: Class I Agents as Sodium Channel Blockers01:22

Antiarrhythmic Drugs: Class I Agents as Sodium Channel Blockers

Class I antiarrhythmic drugs are used to treat various types of arrhythmias or irregular heart rhythms. These drugs block the sodium (Na+) channels in the cardiac cells, thereby affecting the movement of electrical impulses across the heart. Class I antiarrhythmic drugs are divided into three subgroups: Class IA, Class IB, and Class IC, each with distinct mechanisms of action and effects on the heart.
Class 1A Antiarrhythmic Drugs: These drugs work by moderately blocking sodium channels,...
1.8K
Antiarrhythmic Drugs: Class III Agents as Potassium Channel Blockers01:12

Antiarrhythmic Drugs: Class III Agents as Potassium Channel Blockers

Class III antiarrhythmic drugs are a group of medications that can prolong action potentials in the heart. They achieve this by blocking potassium channels or enhancing inward currents from sodium channels. However, these drugs have a unique property of "reverse use-dependence," which is most pronounced at slower heart rates and can lead to torsades de pointes—a specific type of arrhythmia. However, it is essential to note that excessive QT interval prolongation—a measure of...
1.3K
Disorder of Water Balance01:29

Disorder of Water Balance

Water balance disorders are medical conditions that occur when there is a deviation from the body's water volume or osmolarity, disrupting normal homeostasis and leading todehydration, hypotonic hydration, hyperhydration, edema, or water intoxication.
Dehydration
Dehydration occurs when the body loses fluids (particularly water).
Causes:
The major causes of dehydration include excessive sweating, fever, vomiting, diarrhea, and diuresis.
Signs and Symptoms:
Symptoms primarily include intense...
1.4K
Regulation of Water Intake01:25

Regulation of Water Intake

Osmolality refers to the number of solute particles per kilogram of solvent in a solution. Plasma osmolality specifically indicates the total number of solute particles per kilogram of water in blood plasma. This value reflects the body's hydration status and is tightly regulated through mechanisms controlling water intake and output. While water consumption is a conscious decision, the body has intrinsic regulatory systems to maintain fluid balance. Dehydration, a state of water deficit...
1.4K