Wednesday, May 3, 2017

Q; Which of the following anti-seizure medicine has been reported to cause sinus node dysfunction and heart blocks?

A) Carbamazepine 
B) Tegretol 
C) Diazepam 
D) Lacosamide 
E) Levetiracetam


Answer: D

Lacosamide, due to its action enhances the slow inactivation of voltage-dependent sodium channels. This results in cardiac conduction disturbances, mostly atrial fibrillation and atrioventricular block.


References: 

1. Degiorgio CM. (2010) Atrial flutter/atrial fibrillation associated with lacosamide for partial seizures. Epilepsy Behav 18:322–324. 

2. Krause LU, Brodowski KO, Kellinghaus C. (2011) Atrioventricular block following lacosamide intoxication. Epilepsy Behav 20:725–727. 

3. Nizam A, Mylavarapu K, Thomas D, Briskin K, Wu B, Saluja D, Wong S. (2011) Lacosamide-induced second-degree atrioventricular block in a patient with partial epilepsy. Epilepsia 52:e153–e155. 

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