22 research outputs found
Allongement de l’intervalle QT et torsades de pointes associés à la prise de méthadone
Résumé Objectif : Présenter un cas d’allongement de l’intervalle QT et de torsades de pointes à la suite de la prise de hautes doses de méthadone. Résumé du cas : Il s’agit d’un patient de 41 ans atteint du virus de l’immunodéficience humaine qui prend, entre autres, de la méthadone 110 mg TID pour le traitement de douleurs chroniques. À la suite de l’ajout du béthanéchol à son régime médicamenteux pour traiter de la rétention urinaire, le patient a présenté des étourdissements, des palpitations et il s’est évanoui. Il a alors été admis d’urgence à l’hôpital. L’électrocardiogramme a révélé un QT de 502 ms et une arythmie de type torsade de pointes. Discussion : La méthadone est un opioïde synthétique qui peut être utilisé pour le soulagement de la douleur. Il est maintenant reconnu que cet agent peut entraîner un allongement de l’intervalle QT et des torsades de pointes. Cependant, de nombreuses autres causes pharmacologiques et non pharmacologiques peuvent favoriser l’apparition de ces événements. Par exemple, chez ce patient, il est possible que des troubles électrolytiques, de la bradycardie ou un autre médicament que la méthadone aient précipité ce désordre. Conclusion : Lors de l’analyse de profils médicamenteux, il apparaît important de garder à l’esprit que l’allongement de l’intervalle QT et la survenue de torsades de pointes peuvent être d’origine multifactorielle. Abstract Objective: To present a case of prolonged QT interval and torsades de pointes secondary to administration of high doses of methadone. Case Summary: A 41 year old patient with HIV takes, among other medications, 100 mg three times a day of methadone for the treatment of chronic pain. Secondary to the addition of bethanechol to his medication regime to treat urinary retention, the patient suffered dizziness and palpitations, and then fainted. He was then admitted urgently to the hospital. The electrocardiogram revealed a QTc of 502 ms and torsade de pointes arrhythmia. Discussion: Methadone is a synthetic opioid that can be used for pain relief. It is now recognized that this agent can lead to a prolonged QT interval and torsades de pointes. However, numerous other pharmacologic and non-pharmacologic causes can favor the onset of these events. For example, in this patient, it is possible that electrolyte imbalance, bradycardia or a medication other than methadone could have precipitated this outcome. Conclusion: When reviewing medication profiles, it is important to keep in mind that QT interval prolongation and the onset of torsades de pointes can have a multifactorial etiology. Key Words: methadone, QT interval, torsades de pointes
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Results of the radiological survey at 4 Hancock Street, Lodi, New Jersey (LJ060)
Maywood Chemical Works (MCW) of Maywood, New Jersey, generated process wastes and residues associated with the production and refining of thorium and thorium compounds from monazite ores from 1916 to 1956. MCW supplied rare earth metals and thorium compounds to the Atomic Energy Commission and various other government agencies from the late 1940s to the mid-1950s. Area residents used the sandlike waste from this thorium extraction process mixed with tea and cocoa leaves as mulch in their yards. Some of these contaminated wastes were also eroded from the site into Lodi Brook. At the request of the US Department of Energy (DOE), a group from Oak Ridge National Laboratory conducts investigative radiological surveys of properties in the vicinity of MCW to determine whether a property is contaminated with radioactive residues, principally {sup 232}Th, derived from the MCW site. The survey typically includes direct measurement of gamma radiation levels and soil sampling for radionuclide analyses. The survey of this site, 4 Hancock Street, Lodi, New Jersey (LJ060), was conducted during 1985 and 1986. Gamma logging results found during this survey and during a previous survey conducted by Bechtel National, Incorporated, strongly indicated radionuclide concentrations in subsurface soil in excess of DOE remedial action criteria. This finding, coupled with the fact that adjacent properties have been found to be contaminated and that Lodi Brook apparently flows under the property, suggests that it be considered for inclusion in the DOE remedial action program. 5 refs., 4 figs., 4 tabs