PMID- 11760927
OWN - NLM
STAT- MEDLINE
DCOM- 20020220
LR  - 20220419
IS  - 1055-0887 (Print)
IS  - 1055-0887 (Linking)
VI  - 20
IP  - 4
DP  - 2001
TI  - Torsades de pointes associated with high dose levomethadyl acetate (ORLAAM).
PG  - 7-14
AB  - A patient undergoing management of heroin dependency with high dosages of the 
      long-acting methadone derivative, levomethadyl acetate HCl (LAAM; ORLAAM) 
      developed a prolonged QTc interval and polymorphic QRS complexes on EKG 
      consistent with torsades de pointes (TdP). The patient was taking other drugs 
      known to prolong the QTc interval (fluoxetine and IV cocaine), and those known to 
      antagonize the activity of the P450 enzymes responsible for the metabolism of 
      LAAM and its active metabolite (fluoxetine, cocaine and marijuana). No previous 
      reports have appeared in the literature attributing this adverse event to LAAM 
      therapy; however, five similar cases have been reported to the manufacturer. 
      Animal studies indicate that LAAM and metabolites prolong the action potential 
      duration of myocardial cells. We propose that predisposed patients on high doses 
      of LAAM may be at risk for developing TdP. Patients being treated with LAAM 
      should receive dosages consistent with guidelines and be evaluated for 
      concomitant diseases, interacting drug therapies, and EKG abnormalities.
FAU - Deamer, R L
AU  - Deamer RL
AD  - Department of Medical Education, Ventura County Medical Center, CA 93003, USA. 
      bdeamer@venturafpr.com
FAU - Wilson, D R
AU  - Wilson DR
FAU - Clark, D S
AU  - Clark DS
FAU - Prichard, J G
AU  - Prichard JG
LA  - eng
PT  - Case Reports
PT  - Journal Article
PT  - Review
PL  - England
TA  - J Addict Dis
JT  - Journal of addictive diseases
JID - 9107051
RN  - 0 (Narcotics)
RN  - AYI8EX34EU (Creatinine)
RN  - I38ZP9992A (Magnesium)
RN  - L59OC40KWJ (Methadyl Acetate)
RN  - RWP5GA015D (Potassium)
SB  - IM
CIN - J Addict Dis. 2001;20(4):1-5. PMID: 11760922
MH  - Adult
MH  - Creatinine/blood
MH  - Electrocardiography/drug effects
MH  - Female
MH  - Heroin Dependence/*rehabilitation
MH  - Humans
MH  - Magnesium/blood
MH  - Methadyl Acetate/administration & dosage/*adverse effects
MH  - Narcotics/administration & dosage/*adverse effects
MH  - Potassium/blood
MH  - Substance Abuse Detection
MH  - Torsades de Pointes/blood/*chemically induced
RF  - 8
EDAT- 2002/01/05 10:00
MHDA- 2002/02/21 10:01
CRDT- 2002/01/05 10:00
PHST- 2002/01/05 10:00 [pubmed]
PHST- 2002/02/21 10:01 [medline]
PHST- 2002/01/05 10:00 [entrez]
AID - 10.1300/J069v20n04_02 [doi]
PST - ppublish
SO  - J Addict Dis. 2001;20(4):7-14. doi: 10.1300/J069v20n04_02.