BUFLOMEDIL POISONING - 5 CASES WITH CARDIOTOXICITY

Objective: To report cardiotoxicity of buflomedil. Setting: Medical in tensive care unit of a university hospital. Patients: Five patients ad mitted to the hospital since 1985 for buflomedil poisoning. The amount ingested was known for only three patients (3-10.8 g). Results: The f ive young women were admitted to the hospital because of generalized s eizures or myoclonic jerks. Cardiac arrest (asystole) occurred for two of them on admission, 1 and 3 h after ingestion. Electrocardiogram re vealed atrio-ventricular and intraventricular conduction abnormalities , increased QT interval and flattened T wave, decreasing after sodium bicarbonate infusion in two cases. The patients received mechanical ve ntilation, gastric lavage, oral activated charcoal, and clonazepam or valproic acid for convulsions or myoclonic jerks. Epinephrine was admi nistered for cardiac arrest. Sodium bicarbonate was infused in one pat ient on the basis of slightly prolonged QRS duration and in two patien ts due to cardiac arrest. Clinical outcome was good and without sequel ae for all five patients after a few days in the intensive care unit. Conclusion: Clinical and electrocardiographic symptomatology of buflom edil poisoning suggests direct cardiotoxicity, which could be related to possible sodium antagonist properties.