Abstract | OBJECTIVES: BACKGROUND:
Co-proxamol is a common cause of drug-induced death and hospital admission in the United Kingdom. ECG changes following dextropropoxyphene have been reported in animals and man, including QRS prolongation. METHODS: The prospective study was conducted on 15 patients and controls with overdose. A retrospective study of a cohort of 159 co-proxamol overdoses from a combined data set from Edinburgh and Newcastle, Australia was also conducted. The measured or estimated "four hour" plasma paracetamol level was used as a surrogate of the amount of dextropropoxyphene ingested. RESULTS: In the prospective study co-proxamol overdose caused statistically significant QRS prolongation (mean [95% CI] 99.36 [96.19, 102.53] msec), compared to the other combination opioid- paracetamol products (82.84 [80.81, 84.88] msec) but no effect on PR or QTc. QRS duration increase was evident soon after exposure and remained prolonged and stable over the following 24 h. In the retrospective cohort study a dose dependency of effect on QRS was documented, although the correlation coefficient relating paracetamol level to effect was relatively weak (r = 0.338, Sig. [2-tailed] 0.003, n = 74). CONCLUSIONS: QRS is significantly prolonged in co-proxamol overdose, and this prolongation is dose dependent. These findings have clinical relevance to the management of patients with co-proxamol poisoning.
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Authors | R Afshari, S Maxwell, A Dawson, D N Bateman |
Journal | Clinical toxicology (Philadelphia, Pa.)
(Clin Toxicol (Phila))
Vol. 43
Issue 4
Pg. 255-9
( 2005)
ISSN: 1556-3650 [Print] England |
PMID | 16035201
(Publication Type: Comparative Study, Journal Article)
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Chemical References |
- Analgesics, Non-Narcotic
- Analgesics, Opioid
- Drug Combinations
- Acetaminophen
- dihydrocodeine
- Dextropropoxyphene
- Codeine
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Topics |
- Acetaminophen
(poisoning)
- Adult
- Analgesics, Non-Narcotic
(poisoning)
- Analgesics, Opioid
(poisoning)
- Codeine
(analogs & derivatives, poisoning)
- Dextropropoxyphene
(poisoning)
- Drug Combinations
- Drug Overdose
- Electrocardiography
(drug effects)
- Female
- Hemodynamics
(drug effects)
- Humans
- Male
- Prospective Studies
- Retrospective Studies
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