Why the study?
Does concomitant administration of oral erythromycin and quinidine cause torsades de pointes in a patient with atrial fibrillation and pneumonia?
Does concomitant administration of oral erythromycin and quinidine cause torsades de pointes in a patient with atrial fibrillation and pneumonia?
Concomitant administration of oral erythromycin and quinidine can lead to severe QT prolongation, torsades de pointes, and cardiac arrest.
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Supports caution with concomitant quinidine and erythromycin; single case report leaves open need for confirmatory studies.
Torsades de pointes is a polymorphic ventricular tachycardia characterized by marked QT prolongation on the electrocardiogram. It can be induced by both antiarrhythmic and nonantiarrhythmic drugs, such as quinidine and erythromycin. No extensive literature documents an interaction between quinidine and erythromycin when the agents are administered orally. A 95-year-old man received oral quinidine and erythromycin for the treatment of atrial fibrillation and community-acquired pneumonia. He developed torsades de pointes and subsequently cardiac arrest. Since erythromycin and quinidine are known to cause arrhythmias individually, caution and close monitoring are necessary when the drugs are administered concomitantly.
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Lin et al. (1997) studied this question.
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