Agranulocytosis Associated With Disopyramide Therapy

Autor: Conrad, Marcel E., Cumbie, William G., Thrasher, David R., Carpenter, John T.
Zdroj: JAMA: Journal of the American Medical Association; October 1978, Vol. 240 Issue: 17 p1857-1858, 2p
Abstrakt: To the Editor.—Disopyramide phosphate (Norpace) is a newly available type 1 antiarrhythmic drug.1 It is not chemically related to other antiarrhythmic drugs in structure. Similar to quinidine and procainamide, it is useful in the treatment of ectopic ventricular contractions and episodes of ventricular tachycardia and is purported to have less adverse reactions in therapeutic dosages.2 We have treated a patient who had agranulocytosis on two occasions after the administration of disopyramide.Report of a Case.—A 61-year-old man underwent a cholecystectomy during April 1978. During convalescence from surgery ventricular bigeminy developed and was initially treated with quinidine. Inadequate control of his arrhythmia was obtained, and quinidine therapy was discontinued on April 28. Therapy with disopyramide phosphate and procainamide hydrochloride was initiated; a normal WBC count and differential cell count were obtained on that date. On May 11, fever with a suppurative tonsillitis developed; the patient had a
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