ajmaline and Acute-Disease

Topics: Acute Disease; Adult; Aged; Ajmaline; Aminocaproates; Arrhythmias, Cardiac; Clinical Trials as Topic; Female; Heart; Heart Block; Heart Failure; Humans; Male; Middle Aged; Myocardial Infarction; Rupture; Shock, Cardiogenic

We report the cases of 3 patients in whom ajmaline-induced acute hepatitis was followed by anicteric cholestasis persisting for more than 1 year after cessation of administration of the drug. Ajmaline was given for 8-16 days before the onset of acute hepatitis. Jaundice was preceded by fever, chills and abdominal pain, and was associated with hypereosinophilia. The initial lesions included centrilobular cholestasis and portal inflammatory infiltration. Jaundice lasted for 3 weeks to 11 months. In these 3 patients liver tests were still abnormal 17-26 months after ajmaline withdrawal; histological examination, performed 9-26 months after the onset of jaundice, showed a decreased number of interlobular bile ducts, ductular proliferation, and mild portal fibrosis; circulating immune complexes were demonstrated. These observations demonstrate that prolonged cholestasis can follow ajmaline-induced acute hepatitis. Persistence of cholestasis long after the withdrawal of ajmaline suggests some form of autoimmunity.

Topics: Acute Disease; Adult; Ajmaline; Antigen-Antibody Complex; Chemical and Drug Induced Liver Injury; Cholestasis; Estrogens; Female; Humans; Time Factors

A comparative and retrospective study of 59 cases of acute voluntary self-poisoning observed at the Toxicology Department of Fernand Widal Hospital, and 15 cases of complications of the Ajmaline test observed in the Cardiology Department of Bichat Hospital showed a similarity in the cardiac effects of high dosage regardless of the mode of administration of the antiarrhythmic. Acute suicidal poisoning in adults or accidental poisoning in children caused toxic effects at doses over more than Ig: they are characterised by their sudden onset after a latent period of 1 to 2 hours and their short duration (no effects after the 12th hour). The ECG changes included:--First degree atrioventricular block (15 p. 100).--Intraventricular conduction defects were observed in almost all cases. They were proportional to the dose taken and were of prognostic interes (no cardiac arrests when the QRS remained less then 0,2 sec).--ST-T wave changes were observed in all patients. They lasted longer and were of no prognostic importance.--Extrasystoles and ventricular tachycardia are nearly always associated with poor hemodynamic tolerance (70 p. 100 of cardiac arrests, compared to only 16 p. 100 in this absence). This intoxication is serious with a mortality of 24 p. 100 of the reported cases and of 9 p. 100 of cases admitted to an Intensive Care Unit.--The complications of the Ajmaline test were similar, the time of apparition being a few minutes instead of a few hours. There were no deaths or serious hemodynamic complications in this series. This is without doubt related to the observation of the contraindications and the fractional administration of the Ajmaline. We conclude that oral Ajmaline, though well tolerated at therapeutic does may cause severe toxic overdose effects. Although its use remains justified in the treatment of arrhythmias, it should not be used for the symptomatic treatment of palpitations and neurovegetative imbalance.

Topics: Acute Disease; Adult; Ajmaline; Arrhythmias, Cardiac; Child; Electrocardiography; Humans; Retrospective Studies; Suicide

Topics: Acute Disease; Adult; Aged; Ajmaline; Arrhythmias, Cardiac; Bunaftine; Female; Humans; Lidocaine; Male; Middle Aged; Phenytoin; Verapamil

Topics: Acute Disease; Ajmaline; Humans

A 57-year-old man ingested 1,000 mg of ajmaline with suicidal intent. He was unconscious, hypotensive and showed serious disturbances in cardiac conduction on admission. High serum and urine levels of ajmaline were found. Although only 4% of the ingested dose was excreted following forced diuresis, all evidence of toxicity disappeared within 21 h.

Topics: Acute Disease; Ajmaline; Blood Pressure; Electrocardiography; Heart Block; Heart Rate; Humans; Male; Middle Aged; Suicide, Attempted

Liver damage was found in five patients (three men, two women) who were receiving prajmalium bitartrate. The cause was proven by re-exposure which was positive in all instances. The illness tended to start with acute fever and severe upper abdominal pains. When the drug was continued in one case, laparotomy was performed for suspected obstructive jaundice. Another patient had been admitted for operation because of jaundice. On re-exposure the most striking feature was a definite rise in glutamate-dehydrogenase. Prajmalium bitartrate is thus no better tolerated by the liver than ajmalin: both clinically, biochemically and morphologically the two drugs affect the liver similarly.

Topics: Acute Disease; Aged; Ajmaline; Chemical and Drug Induced Liver Injury; Female; Glutamate Dehydrogenase; Humans; Jaundice; Liver; Male; Middle Aged

Topics: Acute Disease; Adolescent; Adult; Ajmaline; Chloroquine; Coma; Digitalis Glycosides; Female; Humans; Male; Middle Aged; Myoclonus; Seizures; Vision Disorders

Topics: Acute Disease; Adult; Aged; Ajmaline; Anti-Arrhythmia Agents; Arrhythmias, Cardiac; Blood Pressure; Carbamates; Coronary Disease; Drug Resistance; Electrocardiography; Female; Heart Rate; Heart Ventricles; Humans; Hypertension; Infusions, Parenteral; Lidocaine; Male; Middle Aged; Myocardial Infarction; Phenytoin; Procainamide; Quaternary Ammonium Compounds; Quinidine; Tachycardia

Topics: Acute Disease; Adult; Aged; Ajmaline; Cardiac Output; Central Venous Pressure; Heart Rate; Humans; Lidocaine; Male; Middle Aged; Myocardial Infarction; Vascular Resistance

Topics: Acute Disease; Ajmaline; Arrhythmias, Cardiac; Coronary Disease; Electrocardiography; Humans; Male; Middle Aged

Topics: Acute Disease; Ajmaline; Bile Ducts, Intrahepatic; Bilirubin; Cholestasis; Chronic Disease; Drug Synergism; Ethinyl Estradiol; Female; Humans; Liver; Liver Function Tests; Male; Methyltestosterone; Microscopy, Electron; Middle Aged; Mononuclear Phagocyte System; Plants, Medicinal; Rauwolfia