Abstract
Pseudoephedrine is a sympathomimetic α- and β-adrenergic receptor agonist that causes vasoconstriction and reduction in edema throughout the nasal passages. Coronary vasospasm associated with pseudoephedrine has been reported in the literature. We discuss the case of a patient with new-onset atrial fibrillation receiving metoprolol for rate control on a background of pseudoephedrine use for allergic rhinitis leading to acute myocardial infarction from multivessel coronary vasospasm. This case illustrates the importance of understanding the pharmacology of potential drug-drug interactions when managing patients with acute cardiovascular syndromes.
Published by Elsevier Inc.
MeSH terms
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Anti-Arrhythmia Agents / administration & dosage
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Anti-Arrhythmia Agents / adverse effects
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Asthma / complications
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Asthma / drug therapy*
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Atrial Fibrillation / complications
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Atrial Fibrillation / diagnosis
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Atrial Fibrillation / drug therapy*
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Bronchodilator Agents / administration & dosage
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Bronchodilator Agents / adverse effects
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Coronary Angiography / methods
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Coronary Vasospasm* / chemically induced
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Coronary Vasospasm* / diagnostic imaging
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Electrocardiography / methods
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Female
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Humans
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Metoprolol* / administration & dosage
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Metoprolol* / adverse effects
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Middle Aged
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Myocardial Infarction* / diagnosis
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Myocardial Infarction* / etiology
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Myocardial Infarction* / physiopathology
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Myocardial Infarction* / therapy
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Nitroglycerin / administration & dosage*
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Pseudoephedrine* / administration & dosage
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Pseudoephedrine* / adverse effects
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Treatment Outcome
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Vasodilator Agents / administration & dosage
Substances
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Anti-Arrhythmia Agents
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Bronchodilator Agents
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Vasodilator Agents
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Pseudoephedrine
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Nitroglycerin
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Metoprolol