Two cases of life-threatening arrhythmia induced by risperidone: evaluation of risperidone and 9-hydroxy-risperidone concentrations.
Two cases of life-threatening arrhythmia induced by risperidone: evaluation of risperidone and 9-hydroxy-risperidone concentrations.
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DOI：
10.1002/ams2.277
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发表时间：
2017-07
影响因子：
1.6
通讯作者：
Imai H
中科院分区：
文献类型：
--
作者：
Ito A;Enokiya T;Kawamoto E;Iwashita Y;Takeda T;Ikemura K;Okuda M;Imai H
案例1：一名20岁的女性因疑似用药过量被送往医院。她表现为心动过缓，QRS波宽，QT延长，随后心脏骤停。实施体外心肺复苏，改善循环。利培酮和9OH - RIS水平分别为9.6 ng/mL和127.6 ng/mL。病例2：一名54岁女性因股骨骨折住院并接受手术治疗。她的心电图显示心动过缓和完全性房室传导阻滞。利培酮和9OH - RIS水平分别为3.2 ng/mL和61.4 ng/mL。在这两种情况下，只有90H‐RIS的血清浓度升高。与利培酮相关的心律失常已被证明是罕见的，但有时是致命的。在这些事件中，利培酮及其代谢物9 -羟基-利培酮（9OH - RIS）的血清浓度很少被记录。由于9OH - RIS显示出与利培酮相当的药理活性，它可能诱发危及生命的心律失常（无论摄入剂量如何）。在怀疑利培酮毒性时，评估血清9OH - RIS浓度至关重要。
Case 1: A 20‐year‐old woman suffering a suspected overdose was transported to the hospital. She presented bradycardia with wide QRS waves and QT prolongation, followed by cardiac arrest. Extracorporeal cardiopulmonary resuscitation was implemented, improving circulation. Risperidone and 9OH‐RIS levels were 9.6 ng/mL and 127.6 ng/mL, respectively. Case 2: A 54‐year‐old woman was hospitalized for femoral fracture and underwent surgery. Her electrocardiogram showed bradycardia and complete AV block. Risperidone and 9OH‐RIS levels were 3.2 ng/mL and 61.4 ng/mL, respectively. In both cases, only serum concentration of 90H‐RIS were elevated. Arrhythmia related to risperidone has proven rare but sometimes fatal. Serum concentrations of risperidone and the metabolite 9‐hydroxy‐risperidone (9OH‐RIS) during these events are seldom documented. As 9OH‐RIS shows pharmacological activity equivalent to risperidone, it may induce life‐threatening arrhythmia (regardless of the intake dosage). It is critical to evaluate the serum concentration of 9OH‐RIS in suspected risperidone toxicity.