engleski

Bradycardia caused by accidental intake of high dose pramipexole

We report “treatment naïve” Parkinson's disease patient who experienced the attack of bradycardia due to the accidental intake of high dose of pramipexole. The male patient, aged 83, with a extrapiramidal symptoms and history of high blood pressure, myocardiopathy and atrial fibrillation during hospitalisation was accidentally given 3 mg of pramipexole. Three hours after he developed bradycardia and hypotension and after an hour the patient completely recovered. Twenty-four-hour ECG showed the basic fibrillation rhythm with an average heart frequency of 55/min, a minimum heart rate of 23/min and a maximum heart rate of 102/min.After gradualy introduction levodopa and ropinirol extended release formulation in therapy patient was free of cardiovascular symptoms. Twenty days after he repeated 24-hour ECG and there were no evidence of bradycardia. Although bradycardia is described as a frequent side effect of the dopamine agonists, pramipexole can rarely cause bradycardia as an adverse event. The report of our patient is important because it worn us about this rear adverse event of pramipexole and also highlight once again need for low and slow titration of dopamine agonists.

pramipexole ; dopamine agonists ; Parkinson disease ; bradycardia

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