0
Comments, Opinions, and Brief Case Reports |

Severe Bradycardia After a Methylprednisolone "Minipulse" Treatment

Radek Pudil, MD, PhD; Zbynek Hrncir, MD, PhD
Arch Intern Med. 2001;161(14):1778-1779. doi:.
Text Size: A A A
Published online

Extract

High-dose intravenous glucocorticoid pulse therapy (0.5-1.0 g) is frequently used to initiate therapy in patients with rapidly progressive, immunologically mediated diseases. Previous observations showed a relatively high number of adverse effects, including cardiotoxicity. Garrett and Paulus1 noticed adverse effects in 56% of patients with rheumatoid arthritis (RA), systemic lupus erythematosus, polymyositis, and dermatomyositis who were receiving intravenous high-dose methylprednisolone therapy. Fatal arrhythmias, cardiac arrest, severe bradycardia, atrial fibrillation, and ventricular arrhythmias have been reported in the course of and in the days after 1 high-dose glucocorticoid treatment.2,3 Recent studies have shown the effectiveness and greater safety of the methylprednisolone "minipulse" treatment. We describe 2 patients who had bradycardia in association with a series of minipulse methylprednisolone treatments (125 mg/d).

Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours

First Page Preview

View Large
/>
First page PDF preview

Figures

Tables

References

Correspondence

CME
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Topics
PubMed Articles
Jobs
JAMAevidence.com

Users' Guides to the Medical Literature
Table 9.2-3 Refuted Evidence From Observational Studiesa

brightcove.createExperiences();