A Case of QT-interval Prolongation in the Context of High-dose, Intravenous Midazolam in a Methadone Maintained Patient

Abstract

The following case illustrates a case of significant prolonged QT-interval (QTc) prolongation following intravenous administration of high-dose midazolam in a patient with severe hyperactive delirium. A prolonged QTc represents a potentially life-threatening condition associated with Torsades de Pointes (TdP) and sudden cardiac death (SCD). Although the predictive value of a prolonged QTc and the occurrence of TdP and SCD has not yet been fully established, heightened awareness in medicine and psychiatry has arisen with respect to the administration of psychotropics. Benzodiazepines, although known to prolong the QTc, have been considered as rather safe medications with this respect. For example, low-dose midazolam has not been shown to cause QTc prolongation. In the following case, however, high-dose midazolam caused a significant prolongation of the QTc, which has to date, not yet been reported.

Authors and Affiliations

Lena Jellestad, Lea Stocker, Josef Jenewein, Soenke Boettger

Keywords

Related Articles

Pneumococcal Osteomyelitis in Children: A Case Report

We describe a case of osteomyelitis, in a 7-month-old boy, caused by S. pneumoniae involving the pelvic bone with a purulent collection in the adductor muscle. Osteomyelitis diagnosis was suspected using ultrasound and C...

Restoration of Maxillary Anterior Teeth with Immediate Implant Placement into Extraction Sites: A Case Report with One Year Follow-Up

The demand for optimal esthetics has increased with the advent of the implant dentistry. It answers many questions concerning esthetics, like replacement of hopeless teeth in esthetic zone of maxillary arch. Now a days i...

Hereditary Juvenile Haemochromatosis and Idiopathic Dilated Cardiomyopathy

Hereditary hemochromatosis (HH), a common autosomal recessive disease, is characterized by excessive iron overload/toxicity in multiple organs (joints, liver, heart, pancreas, pituitary, adrenals and skin). Symptoms and...

Mind the Drain: Inadvertent Colonic Puncture after Mediastinal Drain Insertion in a High-risk Cardiac Surgical Patient

Cardiothoracic surgeries are known to cause gastrointestinal complications due to its proximity to the peritoneal cavity. Such complications in susceptible patients are associated with adverse post-operative outcomes. Wh...

Successful Surgical Removal of an Ectopic Erupted Third Molar in Maxillary Sinus: A Case Report

A 24 year old female complained of recurrent headache, facial fullness and purulent discharge in her mouth. Intra oral examination showed an absence of the right upper third molar with no history of previous extraction....

Download PDF file
  • EP ID EP343612
  • DOI 10.9734/IJMPCR/2015/18840
  • Views 117
  • Downloads 0

How To Cite

Lena Jellestad, Lea Stocker, Josef Jenewein, Soenke Boettger (2015). A Case of QT-interval Prolongation in the Context of High-dose, Intravenous Midazolam in a Methadone Maintained Patient. International Journal of Medical and Pharmaceutical Case Reports, 4(4), 101-104. https://europub.co.uk/articles/-A-343612