| Potential cardiotoxic reaction involving rivastigmine and beta-blockers: a case report and review of the literature. | |
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MedLine Citation:
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PMID: 20865460 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
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We report a case of potential cardiovascular toxicity including syncope, bradycardia, and ECG pauses associated with the use of rivastigmine and atenolol. A 65-year-old African American female with a medical history of dementia, hypertension, seizure disorder, stroke, and peripheral vascular disease was admitted to the hospital with shortness of breath and syncope. She was witnessed to have experienced a presyncopal episode followed by a true syncopal episode in which she was unresponsive for 20-30 s. On day two of hospital stay, the patient's ECG showed a sinus bradycardia with a heart rate in the 40 s and sinus pauses greater than 2 s in duration. Atenolol was immediately discontinued, with a continuance of the bradycardia despite one missed dose. The potentially toxic combination of rivastigmine and atenolol was then identified as a plausible causative factor of this patient's syncope and was subsequently discontinued. This patient's Naranjo adverse reaction probability score was five, which indicates a probable association between syncope and bradycardia with the combination of rivastigmine and atenolol [13]. Following the discontinuation of rivastigmine, the ECG pauses resolved and the patient's heart rate returned to normal levels. The patient did not experience any further dizziness or syncope. A 65-year-old female developed syncope and subsequent ECG pauses with sinus bradycardia after being treated with rivastigmine for dementia. Atenolol may have further compounded this toxic effect by its pharmacodynamic mechanisms. |
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Authors:
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Barbara Paulison; Cara L Léos |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Cardiovascular toxicology Volume: 10 ISSN: 1559-0259 ISO Abbreviation: Cardiovasc. Toxicol. Publication Date: 2010 Dec |
Date Detail:
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Created Date: 2010-11-24 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101135818 Medline TA: Cardiovasc Toxicol Country: United States |
Other Details:
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Languages: eng Pagination: 306-10 Citation Subset: IM |
Affiliation:
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Department of Pharmacy Practice, Auburn University Harrison School of Pharmacy, Auburn University, 1321 Walker Building, Auburn, AL 36849-5501, USA. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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