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Current Drug Safety

Editor-in-Chief

ISSN (Print): 1574-8863
ISSN (Online): 2212-3911

Case Report

Cardiotoxicity Associated with Midazolam in a Patient with Diphtheria

Author(s): Jayendra R. Gohil and Sonal Jindal*

Volume 14, Issue 1, 2019

Page: [57 - 59] Pages: 3

DOI: 10.2174/1574886313666181105122154

Price: $65

Abstract

Background: Adverse cardiorespiratory events are associated with midazolam continuous IV infusion, used for sedation.

History: Here we are reporting a case of 5 year old male child suffering from diphtheria induced airway obstruction, and myocarditis, who received midazolam in the form of IV infusion for sedation while undergoing mechanical ventilation for respiratory failure.

Adverse Event: Six hours after starting midazolam infusion he started developing pulsus bigeminus and bradycardia and eventual death after two hours.

Conclusion: Midazolam, although considered one of the safest drugs, need to be used cautiously in a child with myocarditis, because of the possible cardiotoxic effect in an already affected heart.

Keywords: Cardio-toxicity, midazolam, diphtheria, pulsus bigeminus, myocarditis, bradycardia.

Graphical Abstract

[1]
Midazolam (Versed ®) - Intravenous (IV) Dilution [internet]. 2018[cited 2018 May 23]. Available from: http://www.globalrph.com/midazolam_dilution.htm
[2]
Midazolam Injection patient side effects and drug images 2018. Available from: https://www.rxlist.com/midazolam-injection-drug/patient-images-side-effects.htm
[3]
Reidermann MI. Cardiac complications in adult diphtheria: Analysis of 212 cases. Praxis (Bern 1994) 1996; 85:1647-51.
[4]
Burns E. Myocarditis ECG - life in the fast lane. Medical Blog LITFL ECG Library 2018. Available from: https://lifeinthefastlane.com/ecg-library/myocarditis/
[5]
Cunha JP. RxList common side effects of vancomycin hydrochloride (injection) drug center 2018. Available from: https://www.rxlist.com/vancomycin-injection-side-effects-drug-center.htm
[6]
Jim KF, Matthews WD. An investigation of the cardiotoxic action of vancomycin in the isolated working rat heart. Toxicol In Vitro 1989; 3(1): 27-32.
[7]
Midzee actions, administration, pharmacology 2018. Available from: https://www.ndrugs.com/?s=midzee&t=side%20effects
[8]
Sweetman S, Ed. Martindale: The complete drug reference. Pharmaceutical Press: London, England, UK 2011; p. 414.
[9]
Naranjo CA, Busto U, Sellers EM, et al. A method for estimating the probability of adverse drug reactions. Clin Pharmacol Ther 1981; 30: 239-45.
[10]
Kabara S, Kagawa T, Ikejima N, Takatsuji S, Sueda A. side effects of continuous fentanyl infusion for postoperative pain relief in children. Jpn J Anesthesiol (Masui) 2015; 64(8): 799-803.

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