?url_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Adc&rft.title=Itraconazole-induced+Torsade+de+Pointes+in+a+patient+receiving+methadone+substitution+therapy&rft.creator=Robson+%2C+Noorzurani+&rft.creator=Vicknasingam%2C+B.+&rft.creator=Narayanan%2C+S.&rft.subject=Clinical+Psychology&rft.subject=Social+Psychology&rft.description=Issues.+Methadone%2C+a+pharmacological+agent+used+to+treat+heroin+dependence+is+relatively+safe%2C+but+may+cause+cardiac+arrhythmias+in+the+concurrent+presence+of+other+risk+factors.+Approach+and+Key+Findings.+This+case+report+highlights+the+risk+of+Torsade+de+Pointes%2C+a+life-threatening+cardiac+arrhythmia%2C+in+a+heroin-dependent+patient+receiving+methadone+substitution+therapy+who+was+prescribed+itraconazole+for+vaginal+thrush.+The+patient+presented+to+the+accident+and+emergency+department+for+chest+discomfort+and+an+episode+of+syncope+following+two+doses+of+itraconazole+(200+mg).+Electrocardiogram+monitoring+at+the+accident+and+emergency+department+showed+prolonged+rate-corrected+QT+interval+leading+to+Torsade+de+Pointes.+The+patient+was+admitted+for+cardiac+monitoring%2C+and+electrocardiogram+returned+to+normal+upon+discontinuation+of+methadone.+Implication.+This+cardiac+arrhythmia+was+most+likely+as+a+result+of+a+drug+interaction+between+methadone+and+itraconazole+because+the+patient+presented+with+no+other+risk+factors.+Conclusion.+Given+the+benefits+of+methadone+as+a+substitution+treatment+for+heroin-dependent+individuals%2C+the+association+between+methadone+and+cardiac+arrhythmias+is+of+great+concern.+Physicians+treating+heroin-dependent+patients+on+methadone+substitution+therapy+should+therefore+be+cautious+of+the+potential+risk+of+drug+interactions+that+may+lead+to+fatal+cardiac+arrhythmias.&rft.publisher=Wiley-blackwell+publishing%2C+inc+Malden&rft.date=2009-11&rft.type=Journal+(Paginated)&rft.type=PeerReviewed&rft.format=application%2Fpdf&rft.identifier=http%3A%2F%2Fcogprints.org%2F8116%2F1%2FItraconazole%2520induced%2520Torsade%2520de%2520Pointes.pdf&rft.identifier=++Robson+%2C+Noorzurani++and+Vicknasingam%2C+B.++and+Narayanan%2C+S.++(2009)+Itraconazole-induced+Torsade+de+Pointes+in+a+patient+receiving+methadone+substitution+therapy.++%5BJournal+(Paginated)%5D+++++&rft.relation=http%3A%2F%2Fcogprints.org%2F8116%2F