Donepezil and Memantine-Induced Second-Degree Atrioventricular Block: A Case Report.

IF 0.8 Q4 PHARMACOLOGY & PHARMACY Hospital Pharmacy Pub Date : 2024-10-24 DOI:10.1177/00185787241287368
Manjappa Mahadevappa, Sakeer Hussain, Shivananda Manohar
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Abstract

Donepezil and memantine are second-generation antipsychotics widely used in the management of mild to moderate Alzheimer's disease. These drugs are highly selective for the central nervous system, targeting different neural pathways to mitigate cognitive decline. Donepezil is a reversible and specific acetylcholinesterase inhibitor, while memantine is an NMDA receptor antagonist which modulates glutamatergic activity. Although these medications are safe, they are associated with adverse effects, and cardiovascular complications are rare. The reported cardiac adverse drug reactions include bradycardia, atrioventricular block, and prolonged QT interval. We are reporting a case of an 81-year-old male patient with schizophrenia, Alzheimer's disease and bilateral sensorineural deafness receiving oral donepezil and memantine presented with second-degree atrioventricular block. The patient's atrioventricular block recovered completely in 2 to 3 weeks after the discontinuation of donepezil-memantine and with a short course of sympathomimetic drugs.

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多奈哌齐和美金刚诱发二度房室传导阻滞:病例报告。
多奈哌齐和美金刚是第二代抗精神病药物,广泛用于治疗轻度至中度阿尔茨海默病。这些药物对中枢神经系统具有高度选择性,可针对不同的神经通路缓解认知能力下降。多奈哌齐是一种可逆的特异性乙酰胆碱酯酶抑制剂,而美金刚则是一种 NMDA 受体拮抗剂,可调节谷氨酸能活动。虽然这些药物是安全的,但也会产生不良反应,而心血管并发症则很少见。已报道的心脏不良药物反应包括心动过缓、房室传导阻滞和 QT 间期延长。我们报告了一例 81 岁的男性患者,患有精神分裂症、阿尔茨海默病和双侧感音神经性耳聋,口服多奈哌齐和美金刚,出现二度房室传导阻滞。停用多奈哌齐-美金刚和短期交感神经药物后,患者的房室传导阻滞在 2 至 3 周内完全恢复。
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来源期刊
Hospital Pharmacy
Hospital Pharmacy PHARMACOLOGY & PHARMACY-
CiteScore
1.70
自引率
0.00%
发文量
63
期刊介绍: Hospital Pharmacy is a monthly peer-reviewed journal that is read by pharmacists and other providers practicing in the inpatient and outpatient setting within hospitals, long-term care facilities, home care, and other health-system settings The Hospital Pharmacy Assistant Editor, Michael R. Cohen, RPh, MS, DSc, FASHP, is author of a Medication Error Report Analysis and founder of The Institute for Safe Medication Practices (ISMP), a nonprofit organization that provides education about adverse drug events and their prevention.
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