Atazanavir
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Reactions 1453 - 25 May 2013 S Atazanavir QT prolongation and first-degree atrioventricular block with ventricular tachycardia: case report A 58-year-old man developed QT prolongation and first- degree atrioventricular (AV) block with ventricular tachycardia during atazanavir treatment for HIV infection. The man was HIV infected, and his regular medication included atazanavir 300mg per day [route and duration of therapy before reaction onset not stated]. He was admitted with syncope, and developed hypotension in the emergency room. Ventricular tachycardia ensued. The man was defibrillated and given IV amiodarone. Atazanavir was discontinued as it was suspected of causing QT prolongation. In the ICU, his serial EKG demonstrated ventricular tachycardia which turned to first-degree AV block. His corrected QT intervals were 455ms, 508ms and 400ms at 2, 3 and 6 days after atazanavir withdrawal. Upon improvement in his clinical symptoms and normalisation of QT interval, he was cautiously initiated on lopinavir/ritonavir with continued EKG monitoring. He remained stable with no QT interval prolongation observed. He was subsequently discharged, and attended follow-up in the outpatient clinic with no adverse events noted. Author comment: "[Atazanavir] has been reported to induce prolonged PR interval, first-degree AV block, prolonged QT interval, and Torsades de pointes by inhibiting a rectifier potassium current (Ikr) channel encoded by human ether-a-go-go related gene (HERG)". Santimaleeworagun W, et al. Atazanavir induced first degree atrioventricular block and ventricular tachycardia: A case report. Journal of the Medical Association of Thailand 96: 501-503, No. 4, 2013 - Thailand 803087486 1 Reactions 25 May 2013 No. 1453 0114-9954/10/1453-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
Transcript of Atazanavir
Reactions 1453 - 25 May 2013
SAtazanavir
QT prolongation and first-degree atrioventricularblock with ventricular tachycardia: case report
A 58-year-old man developed QT prolongation and first-degree atrioventricular (AV) block with ventricular tachycardiaduring atazanavir treatment for HIV infection.
The man was HIV infected, and his regular medicationincluded atazanavir 300mg per day [route and duration oftherapy before reaction onset not stated]. He was admittedwith syncope, and developed hypotension in the emergencyroom. Ventricular tachycardia ensued.
The man was defibrillated and given IV amiodarone.Atazanavir was discontinued as it was suspected of causing QTprolongation. In the ICU, his serial EKG demonstratedventricular tachycardia which turned to first-degree AV block.His corrected QT intervals were 455ms, 508ms and 400ms at2, 3 and 6 days after atazanavir withdrawal. Uponimprovement in his clinical symptoms and normalisation ofQT interval, he was cautiously initiated on lopinavir/ritonavirwith continued EKG monitoring. He remained stable with noQT interval prolongation observed. He was subsequentlydischarged, and attended follow-up in the outpatient clinicwith no adverse events noted.
Author comment: "[Atazanavir] has been reported toinduce prolonged PR interval, first-degree AV block,prolonged QT interval, and Torsades de pointes by inhibitinga rectifier potassium current (Ikr) channel encoded by humanether-a-go-go related gene (HERG)".Santimaleeworagun W, et al. Atazanavir induced first degree atrioventricular blockand ventricular tachycardia: A case report. Journal of the Medical Association ofThailand 96: 501-503, No. 4, 2013 - Thailand 803087486
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Reactions 25 May 2013 No. 14530114-9954/10/1453-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
