拉科萨米德治疗后新生儿心脏骤停:一个病例报告
Melissa Ann Huberman1, Carolina Mallar1, Paige M Kalika1
1Department of Pediatric Neurology, University of Miami and Jackson Health System, Miami, Florida.
Pediatric neurology
|November 1, 2023
概括
这项案例研究报告了一种罕见的不良心脏事件,该事件发生在接受lacosamide (一种抗药物) 治疗的新生儿身上. 婴儿经历了心房静脉阻塞和心脏骤停,突出显示新生儿群体的潜在风险.
科学领域:
- 新生儿医学 新生儿医学
- 药理学 药理学是指药理学的学科.
- 心脏病学 心脏病学
背景情况:
- 拉科萨米德是一种FDA批准的抗药,用于1个月以上的患者的部分发作.
- 它通过选择性地增强通道不活化来起作用.
- 虽然一般耐受性很好,但lacosamide与心脏副作用有关,如PR延长和心房门 (AV) 阻塞.
研究的目的:
- 在新生儿患者中报告与lacosamide使用相关的第一个心脏不良事件.
- 突出拉科萨米德在新生儿群体中的潜在风险.
主要方法:
- 一个早产新生儿 (25周怀孕) 的病例报告,因而接受治疗.
- 在开始服用lacosamide之前和之后进行详细的临床观察和心电图 (ECG) 监测.
- 审查患者的病史,包括腹腔内出血和电解质障碍.
主要成果:
- 一个三周大的新生儿在开始服用lacosamide后不久就出现了第二级AV心脏阻塞和心脏骤停.
- 患者在拉科萨米德治疗前没有先前的心脏问题或风险因素.
- 心脏事件得到解决,在停止使用lacosamide后没有观察到复发.
结论:
- 这是首次在接受lacosamide治疗的新生儿中报告AV阻塞的情况.
- 拉科萨米德在新生儿群体中的安全性和有效性需要进一步评估.
- 在给新生儿开拉科萨米德时,必须考虑潜在的心脏风险.
相关概念视频
01:25Cardiopulmonary Resuscitation IV: Pharmacological Management
12
Pharmacologic intervention is crucial in treating cardiac arrest patients during ACLS or Advanced Cardiovascular Life Support. The ACLS algorithms guide the administration of specific drugs based on the patient's cardiac arrest rhythm, which includes pulseless ventricular tachycardia (VT), ventricular fibrillation (VF), asystole, and pulseless electrical activity (PEA).EpinephrineIndication: Epinephrine is the first-line drug for all cardiac arrest rhythms.Mechanism of Action: Epinephrine...
12
01:22Antiarrhythmic Drugs: Class I Agents as Sodium Channel Blockers
1.4K
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,...
Class 1A Antiarrhythmic Drugs: These drugs work by moderately blocking sodium channels,...
1.4K
01:26Heart Failure Drugs: Inotropic Agents
598
Positive inotropic agents are commonly used as the first line of treatment for heart failure. One such agent is digoxin, derived from the genus Digitalis, which has been known for centuries but effectively utilized since 1785. However, these cardiac glycosides can have potentially toxic effects due to their mechanism of action, which involves inhibiting Na+/K+-ATPase and increasing contractility. Digoxin is absorbed orally and distributed in various tissues, including the CNS. It has a long...
598
01:08Antiepileptic Drugs: Sodium Channel Blockers
610
Antiepileptic drugs are specialized medications that prevent seizures in individuals diagnosed with epilepsy. These drugs primarily function by blocking the movement of sodium ions through channels in the neuronal membrane, inhibiting the repetitive firing of action potentials often associated with seizures.
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...
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...
610
01:29Cardiomyopathy V: Interprofessional Care
14
Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...
14
01:25ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias
22
Arrhythmia is a condition characterized by an irregular heart rhythm, with ECG changes that differ based on its origin and nature. The types of arrhythmias discussed below include atrial, junctional, and ventricular arrhythmias.Atrial ArrhythmiasPremature Atrial Complexes (PACs): PACs are early atrial beats caused by stress, caffeine, alcohol, electrolyte imbalances, hypoxia, hyperthyroidism, or certain medications (e.g., bronchodilators and decongestants). The ECG shows early P waves with an...
22