Over the Counter Drugs and Long QT Syndrome: Near Lethal Syncope after Cold Relief by PhenylephrineGiuseppe Di Stolfo*, Sandra Mastroianno, Mauro Pellegrino Salvatori, Raimondo Massaro, Nicola Cianfrone, Aldo Russo, Domenico, Rosario Potenza and Raffaele Fanelli
Cardiovascular Department, “Casa Sollievo della Sofferenza” Hospital, San Giovanni Rotondo, Italy
- *Corresponding Author:
- Giuseppe Di Stolfo
IRCCS “Casa Sollievo della Sofferenza”
71013 San Giovanni Rotondo, Italy
E-mail: [email protected]
Received Date: May 11, 2016; Accepted Date: June 04, 2016; Published Date: June 07, 2016
Citation: Di Stolfo G, Mastroianno S, Salvatori MP, Massaro R, Cianfrone N, et al, (2016) Over the Counter Drugs and Long QT Syndrome: Near Lethal Syncope after Cold Relief by henylephrine. Cardiovasc Pharm Open Access 5:184. doi:10.4172/2329-6607.1000184
Copyright: © 2016 Di Stolfo G, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Introduction: Purpose of this manuscript is a careful reconsideration concerning advantage and risk of selfmedication by Over the Counter (OTC) drugs, in relationship to QTc prolongation, unrevealing concealed QT syndrome and Sudden Arrhythmia Deaths Syndrome (SADS). Case presentation: A 64-year old lady was carried to the Emergency Department after traumatic syncope. The patient was found at home with a bruised occipital wound and retrograde amnesia; in the previous two day she had a common cold and bought an OTC (Over the Counter) formulation composed by paracetamol, ascorbic acid and phenylephrine cloridrate. ECG showed ventricular repolarization abnormality compatible with induced long QT syndrome. In the subsequent days, as phenylephrine was withdrawn, we observed a constant reduction of QT, yet still a long QTc. On the basis of clear syncope and Long QT syndrome unrevealed by phenylephrine treatment, ICD was implanted. Conclusion: Widespread self-medication for cold relief is usually perceived as safe treatment by general population; nevertheless, in some OTC, patient could encounter medicament belonging to specific “drug to avoid list” for SADS, leading to harmful impact on prognosis.