000			03513nam a22005177a 4500
008			191119s20192019 xxu||||| |||| 00| 0 eng d
022			_a0749-5161
024			_a10.1097/PEC.0000000000001502 [doi]
040			_aOvid MEDLINE(R)
099			_a29746361
245			_aProlonged QRS Widening After Aripiprazole Overdose.
251			_aPediatric Emergency Care. 35(11):e209-e212, 2019 Nov.
252			_aPediatr Emerg Care. 35(11):e209-e212, 2019 Nov.
252			_zPediatr Emerg Care. 35(11):e209-e212, 2019 Nov.
253			_aPediatric emergency care
260			_c2019
260			_fFY2020
265			_sppublish
266			_d2019-11-19
268			_aPediatric Emergency Care. 35(11):e209-e212, 2019 Nov.
501			_aAvailable online from MWHC library: 2000 - present
520			_aBACKGROUND: Aripiprazole is an atypical antipsychotic with a long half-life. Overdose can result in protracted somnolence and cardiac disturbances, particularly QT interval prolongation.
520			_aCASE: A 14-year-old boy intentionally ingested 20 tablets of aripiprazole (5 mg). He was brought to the emergency department when his ingestion was discovered. The patient's vital signs were as follows: temperature, 37.7degreeC; heart rate, 108 beats/min; blood pressure, 138/98 mm Hg; and respirations, 16 breaths/min. Activated charcoal was administered within 90 minutes of ingestion. Initial electrocardiogram (EKG) showed sinus tachycardia, with a QRS of 138 ms and QT interval of 444 ms. QRS duration was 90 ms on an EKG performed 3 months earlier. A bolus of sodium bicarbonate was administered, and the patient was transferred to the pediatric intensive care unit. Repeat EKG demonstrated a QRS of 156 ms, and a sodium bicarbonate infusion was initiated. The patient continued to have QRS prolongation for the next 8 days, reaching a peak of 172 ms 3 days postingestion. Despite aggressive treatment with sodium bicarbonate, there was persistent QRS prolongation; however, the patient did not have any dysrhythmias and remained hemodynamically stable. The patient was discharged 9 days postingestion when the QRS duration normalized to 82 ms. Genetic testing revealed that the patient was a CYP2D6 poor metabolizer.
520			_aCONCLUSIONS: This case suggests that aripiprazole toxicity may possibly be associated with QRS prolongation without associated dysrhythmias or cardiovascular compromise. In addition, toxicity may be prolonged in patients who are CYP2D6 poor metabolizers.
520			_aMETHODS: This is a single case report of a 14-year-old boy who took an overdose of aripiprazole and developed QRS widening.
546			_aEnglish
650			_a*Antidepressive Agents/po [Poisoning]
650			_a*Aripiprazole/po [Poisoning]
650			_a*Long QT Syndrome/ci [Chemically Induced]
650			_a*Tachycardia, Sinus/ci [Chemically Induced]
650			_aAdolescent
650			_aAntidepressive Agents/pd [Pharmacology]
650			_aAripiprazole/pd [Pharmacology]
650			_aDrug Overdose/ge [Genetics]
650			_aElectrocardiography
650			_aHumans
650			_aMale
651			_aMedStar Washington Hospital Center
656			_aEmergency Medicine
657			_aJournal Article
700			_aDewey, Kayla
700			_aMazer-Amirshahi, Maryann
790			_aDewey K, Mazer-Amirshahi M, Porter R
856			_uhttps://dx.doi.org/10.1097/PEC.0000000000001502 _zhttps://dx.doi.org/10.1097/PEC.0000000000001502
942			_cART _dArticle
999			_c4747 _d4747