Dextropropoxyphene and the cardiovascular system: About two cases of acute poisoning with cardiac conduction abnormalities

Authors

  • Frédérik Staikowsky, MD, PhD
  • Sébastien Candella, MD
  • Maurice Raphael, MD

DOI:

https://doi.org/10.5055/jom.2005.0052

Keywords:

-

Abstract

-

Author Biographies

Frédérik Staikowsky, MD, PhD

Emergency Department and SMUR, Groupe Hospitalier Sud Réunion, St. Pierre Cedex, France.

Sébastien Candella, MD

Emergency Department, CHU Tenon, Paris, France.

Maurice Raphael, MD

Emergency Department, CHIC, Montfermeil, France.

References

Hawton K, Simkin S, Deeks J: Co-proxamol and suicide: A study of national mortality statistics and local non-fatal self poisonings. BMJ. 2003; 326(7397): 1006-1008.

Jonasson B, Jonasson U, Saldeen T: Suicides may be overreported and accidents underreported among fatalities due to dextropropoxyphene. J Forensic Sci. 1999; 44(2): 334-338.

Madsen PS, Strom J, Reiz S, et al.: Acute propoxyphene selfpoisoning in 222 consecutive patients. Acta Anaesthesiol Scand. 1984; 28(6): 661-665.

Staikowsky F, Theil F, Mercadier P, et al.: Change in profile of acute self drug-poisonings over a 10-year period. Hum Exp Toxicol. 2004; 23(11): 507-511.

Hartman B, Miyada DS, Pirkle H, et al.: Serum propoxyphene concentrations in a cohort of opiate addicts on long-term propoxyphene maintenance therapy. Evidence for drug tolerance in humans. J Anal Toxicol. 1988; 12(1): 25-29.

Britain Committee on Safety of Medicines news release. Available online at: http://www.mca.gov.uk/aboutagency/regframework/csm/csmhome.htm.

Amsterdam EA, Rendig SV, Henderson GL, et al.: Depression of myocardial contractile function by propoxyphene and norpropoxyphene. J Cardiovasc Pharmacol. 1981; 35(1): 129-138.

Hantson P, Evenepoel M, Ziade D, et al.: Adverse cardiac manifestations following dextropropoxyphene overdose: Can naloxone be helpful? Ann Emerg Med. 1995; 25(2): 263-266.

Holland DR, Steinberg MI: Electrophysiologic properties of propoxyphene and norpropoxyphene in canine cardiac conducting tissues and in vivo. Toxicol Appl Pharmacol. 1979; 47(1): 123-133.

Bredgaard Sorensen M, Haggmark S, Nyhman H, et al.: Circulatory shock following intravenous propoxyphene poisoning. An experimental study of cardiac function and metabolism in pentobarbital-anesthetized pigs. Acta Anaesthesiol Scand. 1985; 29(1): 130-136.

Strom J, Haggmark S, Madsen PS, et al.: The effects of naloxone on central hemodynamics and myocardial metabolism in experimental propoxyphene-induced circulatory shock. Acta Anaesthesiol Scand. 1985; 29(7): 693-697.

Whitcomb DC, Gilliam FR, Starmer CF, et al.: Marked QRS complex abnormalities and sodium channel blockage by propoxyphene reversed with lidocaïne. J Clin Invest. 1989; 84(5): 1629-1636.

Ulens C, Daenens P, Tytgat J: Norpropoxyphene-induced cardiotoxicity is associated with changes in ion-selectivity and gating of HERG currents. Cardiovasc Res. 1999; 44(3): 568-578.

Wu C, Fry CH, Henry J: The mode of action of several opioids on cardiac muscle. Exp Physiol. 1997; 82(2): 261-272.

Kienbaum P, Thurauf N, Scherbaum N, et al.: Profound increase in epinephrine concentration in plasma and cardiovascular stimulation after mu-opioid receptor blockage in opioidaddicted patients during barbiturate-induced anesthesia for acute detoxification. Anesthesiology. 1998; 88(5): 1154-1161.

Pedersen CB, Strom J, Angelo HR, et al.: Dopamine and dobutamine reduce myocardial d-propoxyphene content in experimentally intoxicated rats. Hum Exp Toxicol. 1991; 10(2): 109-112.

Krantz T, Thisted B, Strom J, et al.: Severe acute propoxyphene overdose: Plasma concentrations of propoxyphene and norpropoxyphene and the effect of dopamine on circulatory failure. Acta Anaesthesiol Scand. 1986; 30(4): 271-276.

Stork CM, Redd JT, Fine K, et al.: Propoxyphene-induced wide QRS complex dysrhythmia responsive to sodium bicarbonate. J Toxicol Clin Toxicol. 1995; 33(2): 179-183.

Downloads

Published

11/01/2005

How to Cite

Staikowsky, MD, PhD, F., S. Candella, MD, and M. Raphael, MD. “Dextropropoxyphene and the Cardiovascular System: About Two Cases of Acute Poisoning With Cardiac Conduction Abnormalities”. Journal of Opioid Management, vol. 1, no. 5, Nov. 2005, pp. 240-3, doi:10.5055/jom.2005.0052.

Issue

Section

Case Studies