| Popis: |
BACKGROUND: Prescribing cascade is the situation in which a first drug administered to a patient causes adverse reactions that are misinterpreted as a new condition, resulting in a new medication being prescribed. PURPOSE: To report the case of a patient who suffered serious psychiatric disorders and a cardiopulmonary arrest probably related to prescribing cascade. MATERIAL AND METHODS: A descriptive study was made by reviewing the electronic medical record of a 55-year-old man with a history of pulmonary thromboembolism, anxiety and behaviour disorder, and chronic diarrhoea. RESULTS: Due to his medical history the patient was anticoagulated, and since February 2014 he was taking haloperidol 2 mg and escitalopram 15 mg daily. In September 2014, he was admitted to the Emergency Department (ED) because of acute ischaemic heart disease, with a cardiopulmonary arrest (CPA) due to a Torsades de pointes tachycardia related to a long QT secondary to haloperidol and escitalopram. Moreover, he was diagnosed with gastropathy by stress, so treatment was initiated with a proton pump inhibitor (PPI). Almost a year after the CPA, the patient was admitted to the Psychiatry Department because of the worsening of his pathology, and during the hospitalisation, low serum magnesium levels were observed ( |
