Ventricular tachycardia after naloxone administration in an adolescent

Catherine E Naber; Nonyerem O Acholonu; Neil D Fernandes; Brian P Sanders; Lauren Sweetser; Michael R Flaherty; Manuella Lahoud-Rahme; Phoebe H Yager

doi:10.1016/j.ajem.2021.05.083

Ventricular tachycardia after naloxone administration in an adolescent

Am J Emerg Med. 2021 Nov:49:300-301. doi: 10.1016/j.ajem.2021.05.083. Epub 2021 Jun 10.

Authors

Catherine E Naber¹, Nonyerem O Acholonu², Neil D Fernandes¹, Brian P Sanders³, Lauren Sweetser¹, Michael R Flaherty¹, Manuella Lahoud-Rahme⁴, Phoebe H Yager⁵

Affiliations

¹ Division of Pediatric Critical Care Medicine, Department of Pediatrics, Massachusetts General Hospital for Children, Harvard Medical School, 175 Cambridge Street, 5(th) Floor, Boston, MA 02114, United States; Department of Pediatrics, Massachusetts General Hospital for Children, Harvard Medical School, 175 Cambridge Street, 5(th) Floor, Boston, MA 02114, United States.
² Department of Pediatrics, Massachusetts General Hospital for Children, Harvard Medical School, 175 Cambridge Street, 5(th) Floor, Boston, MA 02114, United States.
³ Department of Pediatrics, Massachusetts General Hospital for Children, Harvard Medical School, 175 Cambridge Street, 5(th) Floor, Boston, MA 02114, United States; Department of Pediatric Emergency Medicine, Department of Pediatrics, Massachusetts General for Children at North Shore Medical Center, 57 Highland Avenue, Salem, MA 01970, United States.
⁴ Division of Pediatric Critical Care Medicine, Department of Pediatrics, Massachusetts General Hospital for Children, Harvard Medical School, 175 Cambridge Street, 5(th) Floor, Boston, MA 02114, United States; Department of Pediatrics, Massachusetts General Hospital for Children, Harvard Medical School, 175 Cambridge Street, 5(th) Floor, Boston, MA 02114, United States; Division of Pediatric Cardiology, Department of Pediatrics, Massachusetts General Hospital for Children, Harvard Medical School, 175 Cambridge Street, 5(th) Floor, Boston, MA 02114, United States.
⁵ Division of Pediatric Critical Care Medicine, Department of Pediatrics, Massachusetts General Hospital for Children, Harvard Medical School, 175 Cambridge Street, 5(th) Floor, Boston, MA 02114, United States; Department of Pediatrics, Massachusetts General Hospital for Children, Harvard Medical School, 175 Cambridge Street, 5(th) Floor, Boston, MA 02114, United States. Electronic address: pyager@mgh.harvard.edu.

PMID: 34182273
DOI: 10.1016/j.ajem.2021.05.083

Abstract

Naloxone is a medication with a largely benign safety profile that is frequently administered in the emergency department to patients presenting with altered mental status. Ventricular tachycardia has been reported after naloxone administration in adult patients with prior use of opiate or sympathomimetic medications. However, no such reports exist in the pediatric population or in patients who have no known history of opiate or sympathomimetic medication use. We describe a case of ventricular tachycardia after naloxone administration in a 17-year-old male with no known prior use of opiate or sympathomimetic agents who presented to the emergency department with altered mental status of unknown etiology. Emergency physicians may wish to prepare for prompt treatment of ventricular arrythmias when administering naloxone to pediatric patients presenting with altered mental status.

Keywords: Naloxone; Pediatrics; Ventricular tachycardia.

Publication types

Case Reports

MeSH terms

Adolescent
Drug Overdose / drug therapy
Female
Humans
Naloxone / adverse effects*
Naloxone / therapeutic use
Narcotic Antagonists / adverse effects
Narcotic Antagonists / therapeutic use
Tachycardia, Ventricular / etiology*

Substances

Narcotic Antagonists
Naloxone