A Rare Case Report of “Torsades De Pointes” Induced by Fluconazole-Levetiracetam Combined Therapy
P. M. Mulendelé
Department of Cardiology, P37, Ibn Rochd University Hospital, Casablanca, Morocco.
M. Njie *
Department of Cardiology, P37, Ibn Rochd University Hospital, Casablanca, Morocco.
M. B. Charfo
Department of Cardiology, P37, Ibn Rochd University Hospital, Casablanca, Morocco.
S. M. Boutar
Department of Cardiology, P37, Ibn Rochd University Hospital, Casablanca, Morocco.
B. E. Ovaga
Department of Cardiology, P37, Ibn Rochd University Hospital, Casablanca, Morocco.
M. Haboub
Department of Cardiology, P37, Ibn Rochd University Hospital, Casablanca, Morocco and Faculty of Medicine and Pharmacy, Hassan II University of Casablanca, Casablanca, Morocco.
S. Arous
Department of Cardiology, P37, Ibn Rochd University Hospital, Casablanca, Morocco and Faculty of Medicine and Pharmacy, Hassan II University of Casablanca, Casablanca, Morocco.
M. Ghali Benouna
Department of Cardiology, P37, Ibn Rochd University Hospital, Casablanca, Morocco and Faculty of Medicine and Pharmacy, Hassan II University of Casablanca, Casablanca, Morocco.
A. Drighil
Department of Cardiology, P37, Ibn Rochd University Hospital, Casablanca, Morocco and Faculty of Medicine and Pharmacy, Hassan II University of Casablanca, Casablanca, Morocco.
L. Azzouzi
Department of Cardiology, P37, Ibn Rochd University Hospital, Casablanca, Morocco and Faculty of Medicine and Pharmacy, Hassan II University of Casablanca, Casablanca, Morocco.
R. Habbal
Department of Cardiology, P37, Ibn Rochd University Hospital, Casablanca, Morocco and Faculty of Medicine and Pharmacy, Hassan II University of Casablanca, Casablanca, Morocco.
*Author to whom correspondence should be addressed.
Abstract
Drugs used to treat cardiovascular disease as well as those used in the treatment of multiple other conditions can occasionally produce exaggerated prolongation of the QT interval on the surface electrocardiogram and the morphologically distinctive polymorphic ventricular tachycardia that results is known as «torsade de pointe». «Torsade de pointe» (TDP) is a characteristic polymorphic ventricular arrhythmia associated with delayed ventricular repolarization as evidenced on the surface electrocardiogram by QT interval prolongation. It typically occurs in self-limiting bursts, causing dizziness and syncope, but may occasionally progress to ventricular fibrillation and sudden death. This rare case report showed the potential higher risk of the occurrences of «Tdp» when levetiracetam (KEPPRA) was used in combination therapy with fluconazole, which is already a known medication with the risk of causing polymorphic ventricular arrhythmia.
Keywords: Torsades de pointes, prolong QT interval, fluconazole-levetiracetam, magnesium therapy