Prolonged QT interval, syncope, and delirium with galantamine

The Annals of Pharmacotherapy
Alexander A Fisher, Michael W Davis

Abstract

To describe a case of QT interval prolongation, syncope, and delirium associated with galantamine use and to analyze similar cases related to acetylcholinesterase inhibitors (AChIs) reported to the Australian Adverse Drug Reaction Advisory Committee (ADRAC). An 85-year-old man with dementia was treated with prolonged release galantamine 8 mg daily for 1.5 years. Three months prior to the current admission, he had a syncopal episode with low blood pressure and bradycardia. Two months later, galantamine was withdrawn, but within 2 weeks, the man developed marked cognitive, behavioral, and functional deterioration and galantamine was restarted. Three weeks later, he developed syncope, delirium, hypotension, and prolonged QT interval with serious cardiac arrhythmias, in addition to vomiting and diarrhea. A complete blood cell count and biochemistry panel performed on admission were normal. No infection was detected. Galantamine and irbesartan were ceased. The delirium fully resolved in 6 days, and the QT interval shortened from 503 to 443 msec (corrected by Bazett's formula) 4 days after discontinuation of galantamine and remained normal. In the ADRAC reports, galantamine was associated with 18 cases of delirium/confusion, 8 of syn...Continue Reading

References

Nov 21, 1977·JAMA : the Journal of the American Medical Association·A Baraka, S Harik
Oct 1, 1991·Clinical Pharmacology and Therapeutics·U BickelH Kewitz
Dec 1, 1983·Journal of the American College of Cardiology·J B MartinsD D Lund
Aug 1, 1981·Clinical Pharmacology and Therapeutics·C A NaranjoD J Greenblatt
Aug 29, 2001·Clinical Pharmacokinetics·M R Marino, N N Vachharajani
May 2, 2002·The British Journal of Psychiatry : the Journal of Mental Science·E Walsh, J Dourish
Sep 1, 2004·Expert Opinion on Drug Safety·Sarah ThompsonNathan Herrmann
Nov 10, 2004·Journal of Electrocardiology·Shen LuoPeter W Macfarlane
Aug 3, 2005·Drugs & Aging·Philippe BordierAlexia Lafitte
Nov 9, 2005·Journal of the American Geriatrics Society·Abid Iraqi, Terry Lynn Hughes
Jan 24, 2006·The Journal of Clinical Psychiatry·Matthew W Nelson, Robert W Buchanan
Jan 27, 2006·The Cochrane Database of Systematic Reviews·C Loy, L Schneider
Jan 27, 2006·The Cochrane Database of Systematic Reviews·J Birks
Mar 17, 2006·The New England Journal of Medicine·Sharon K Inouye
Jul 22, 2006·Emergency Medicine Journal : EMJ·T SuleymanS Ozlem
Feb 6, 2007·Journal of Electrocardiology·Jay W MasonBoaz Mendzelevski
May 1, 2007·The American Journal of Medicine·Martin R Farlow, Jeffrey L Cummings

❮ Previous
Next ❯

Citations

Apr 30, 2014·Drug Safety : an International Journal of Medical Toxicology and Drug Experience·Laurence Guy Howes
Sep 24, 2014·Tijdschrift voor gerontologie en geriatrie·I C Jobse, R A M de Jonckheere
Jan 6, 2012·The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences·F Javier Ortiz-AlonsoJose A Serra-Rexach
Feb 2, 2010·Expert Opinion on Drug Metabolism & Toxicology·David PrvulovicJohannes Pantel
Feb 22, 2011·The American Journal of Geriatric Pharmacotherapy·Ahmet Turan IsikSelim Kilic
Oct 23, 2009·La Revue de médecine interne·A PiauB Vellas
Apr 10, 2009·Pharmacoepidemiology and Drug Safety·Elisabetta PoluzziFabrizio De Ponti
Oct 2, 2009·Journal of the American Geriatrics Society·Rohini K HernandezElizabeth V Lawler
Jun 9, 2011·Journal of the American Geriatrics Society·Dae Hyun KimSarah D Berry
Dec 1, 2009·Journal of cardiology·Tomofumi TakayaSeinosuke Kawashima
Jul 12, 2018·Psychogeriatrics : the Official Journal of the Japanese Psychogeriatric Society·Tomoki HanazawaYoshiyuki Haga
Nov 24, 2016·Zeitschrift für Gerontologie und Geriatrie·Galia JackobsonDan Justo
Sep 17, 2019·Journal of Alzheimer's Disease : JAD·Miika LinnaTero Ylisaukko-Oja
May 10, 2020·American Journal of Alzheimer's Disease and Other Dementias·Meiqi HeInmaculada Hernandez
Sep 3, 2020·Therapeutic Advances in Drug Safety·Katie Malone, Jules C Hancox
Jan 20, 2016·Journal of the American Geriatrics Society·Kosuke KajitaniToru Maruyama

❮ Previous
Next ❯

Related Concepts

Related Feeds

Bradyarrhythmias

Bradyarrhythmias are slow heart rates. Symptoms may include syncope, dizziness, fatigure, shortness of breath, and chest pains. Find the latest research on bradyarrhythmias here.

Atrial Fibrillation

Atrial fibrillation is a common arrhythmia that is associated with substantial morbidity and mortality, particularly due to stroke and thromboembolism. Here is the latest research.

Arrhythmia

Arrhythmias are abnormalities in heart rhythms, which can be either too fast or too slow. They can result from abnormalities of the initiation of an impulse or impulse conduction or a combination of both. Here is the latest research on arrhythmias.

Related Papers

The Journal of Clinical Psychiatry
Matthew W Nelson, Robert W Buchanan
The Journal of Clinical Psychiatry
H Robert Brashear, J Michael Spivey
Clinical Pharmacokinetics
Martin R Farlow
© 2021 Meta ULC. All rights reserved