Unusual case of severe arrhythmia developed after acute intoxication with tosylchloramide

Lariccia, Vincenzo; Moraca, Alessandra; Marini, Marco; Nasti, Annamaria Assunta; Battistoni, Ilaria; Amoroso, Salvatore; Perna, Gian Piero

doi:10.1186/2050-6511-14-8

Cited by 5 publications

(2 citation statements)

References 33 publications

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“…Aforementioned formulations are granules that need to be dissolved in water. Being such formulations similar to granulates of other active ingredients that are supposed to be used orally, patients tends to get confused ingesting the topic solution of tosylchloramide sodium orally (Lariccia et al, 2013 ). By looking at the percentage distribution of adverse drug reactions, as expected, the most representative were “type A” adverse drug reactions (or rather dose-dependent adverse drug reactions according to Rawlins and Thompson classification Rawlins, 1977 ).…”

Section: Discussionmentioning

confidence: 99%

Pillars and Pitfalls of the New Pharmacovigilance Legislation: Consequences for the Identification of Adverse Drug Reactions Deriving From Abuse, Misuse, Overdose, Occupational Exposure, and Medication Errors

et al. 2018

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Rationale: The aim of this study is to investigate if following the implementation of the Regulation EU/1235/2010 and the Directive 2010/84/EU there was an increase of individual case safety reports (ICSRs) deriving from a medication error, abuse, misuse, overdose, or occupational exposure. Other objectives are the identification of drugs mostly involved in such cases, to establish if the codification of aforementioned conditions is performed correctly and, whenever codification errors exist, to identify predictors of codification errors. Finally, we estimated the magnitude of these errors on signal detection activities.Methods: ICSRs sent through Campania Region (Italy) spontaneous reporting system from July 2nd 2012 to December 31th 2017 were used as data source. A multivariable logistic regression model was used to identify predictors of codification errors. Four measures of disproportionality were used to investigate the magnitude of codification errors on a known safety signal or rather the association between benzodiazepines derivatives and abuse.Results: In all, 358 (1.4%) out of 25610 ICSRs reported “non-normal use” of drugs, mainly as cases of abuse. Drugs mostly involved in abuse were “Benzodiazepines derivatives” (171/358; 47.8%). For medication errors instead, “Other antiseptics and disinfectants” (9/358; 2.5%). At the first quality control, 125 (34.9%) out of 358 ICSRs did not have a codification of “non-normal use” or codifications were performed wrongly. Codification errors included misclassification of abuse as overdose (10/125; 8.0%) and misclassification of medication error as overdose (7/125; 5.6%) or abuse (7/125; 5.6%). Compared to pharmaceutical companies, patients/citizens (as reporters) had a 24.88 higher odd (Reporting Odds Ratio 24.88, 95%CI 1.82–449.95; p-value: 0.02) of performing un-classification or misclassification of aforementioned codifications. Codification errors were associated with the underestimation of measure of disproportionality' estimates in the identification of the safety signal “Benzodiazepine derivatives /abuse”.Conclusion: In conclusion, this study found that in Campania Region (southern Italy) there was an exponential increase of ICSR reporting “non-normal use,” mainly as cases of abuse, with an improvable proportion of cases misclassified/unclassified. Moreover, this study found that ICSRs sent by patients/citizens were associated with an increased odd of un-classification or misclassification that had a relevant impact on signal detection activities.

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Section: Discussionmentioning

confidence: 99%

Pillars and Pitfalls of the New Pharmacovigilance Legislation: Consequences for the Identification of Adverse Drug Reactions Deriving From Abuse, Misuse, Overdose, Occupational Exposure, and Medication Errors

et al. 2018

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“…Congenital or acquired causes are included in the etiology of QT interval prolongation, also known as long QT syndrome (LQTS) [ 8 ]. Electrolyte abnormalities, sinus node dysfunction, atrioventricular blocks, myocardial ischemia, intoxications, and medication use are among the acquired etiological causes [ 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

Relationship between a Prolonged Corrected QT Interval and Mortality in Patients Presenting with Syncope at the Emergency Department

Akyol

Acar

Çakır

et al. 2021

BioMed Research International

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Background. Syncope is a common symptom in emergency department patients. Among various etiological factors, cardiac causes have the highest risk of mortality. The corrected QT interval is considered an independent predictor of mortality for many diseases. Objectives. Analyze QT interval analysis of patients presenting to the emergency department with syncope. Methods. In this prospective observational study, patients who presented to the emergency department with syncope between January 1, 2018, and January 1, 2019 were included. Results. The median age was 64 (49-78) years, and 58.8% of patients were male. The corrected QT interval (QTc) in patients with coronary artery disease and chronic obstructive pulmonary disease was longer than those without. There was no statistically significant association between hypertension, diabetes, stroke, thyroid disease, and prolonged QTc. Patients who did not survive had significantly prolonged QT intervals. According to ROC analysis, sensitivity of >440.5 ms QTc values in predicting mortality was 86% and specificity was 71% ( AUC = 0.815 ; 95 % CI = 0.71 − 0.91 ; p < 0.001 ). Conclusions. Patients admitted to emergency department with syncope and a prolonged QTc are associated with a higher mortality rate and thus can provide us with an important guide for the management of these patients.

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Unusual case of severe arrhythmia developed after acute intoxication with tosylchloramide

Cited by 5 publications

References 33 publications

Pillars and Pitfalls of the New Pharmacovigilance Legislation: Consequences for the Identification of Adverse Drug Reactions Deriving From Abuse, Misuse, Overdose, Occupational Exposure, and Medication Errors

Pillars and Pitfalls of the New Pharmacovigilance Legislation: Consequences for the Identification of Adverse Drug Reactions Deriving From Abuse, Misuse, Overdose, Occupational Exposure, and Medication Errors

Relationship between a Prolonged Corrected QT Interval and Mortality in Patients Presenting with Syncope at the Emergency Department

Chloramine T

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