<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0120-8705</journal-id>
<journal-title><![CDATA[CES Medicina]]></journal-title>
<abbrev-journal-title><![CDATA[CES Med.]]></abbrev-journal-title>
<issn>0120-8705</issn>
<publisher>
<publisher-name><![CDATA[Universidad CES]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0120-87052019000300201</article-id>
<article-id pub-id-type="doi">10.21615/cesmedicina.33.3.5</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Glucantime y prolongación del intervalo QTc: una combinación fatal]]></article-title>
<article-title xml:lang="en"><![CDATA[Glucantime and QTc interval prolongation: A fatal combination]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Duque]]></surname>
<given-names><![CDATA[Laura]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[López]]></surname>
<given-names><![CDATA[Helber G.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Naranjo]]></surname>
<given-names><![CDATA[Sebastián]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Aristizábal]]></surname>
<given-names><![CDATA[Julián M.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Duque]]></surname>
<given-names><![CDATA[Mauricio]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad CES  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Colombia</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Universidad CES  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Colombia</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Universidad CES  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Colombia</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,Universidad CES  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Colombia</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>12</month>
<year>2019</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>12</month>
<year>2019</year>
</pub-date>
<volume>33</volume>
<numero>3</numero>
<fpage>201</fpage>
<lpage>207</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_arttext&amp;pid=S0120-87052019000300201&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_abstract&amp;pid=S0120-87052019000300201&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_pdf&amp;pid=S0120-87052019000300201&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen La leishmaniosis cutánea es una enfermedad causada por un parásito pro tozoo intracelular; el glucantime es una opción terapéutica, aunque está asociado con alteraciones cardiovasculares, siendo la más frecuente la prolongación del intervalo QTc que se presenta entre el 17,8 % y 19 % de los pacientes. Si este efecto no es detectado a tiempo puede causar una arritmia fatal por torsade de pointes. Se presenta el caso de una paciente de 77 años quien se encontraba en tratamiento con glucantime intramus cular como tratamiento de leishmaniosis cutánea e ingresó por un cuadro clínico de hipocalemia severa refractaria y episodios de torsade de pointes; posteriormente, presentó fibrilación ventricular que no respondió a des fibrilación y reanimación. Las alteraciones en la repolarización cardiaca producidas por este medicamento se consideran secundarias a la acu mulación de compuestos pentavalentes y trivalentes en el miocardio. No existe tratamiento específico para esta situación, pero siempre se debe realizar manejo de soporte, evitar fármacos que prolonguen el intervalo QT, normalizar los niveles de potasio y de magnesio, elevar la frecuencia cardiaca con isoproterenol e implantar marcapaso transvenoso para lograr sobre-estimulación y reducción de los periodos refractarios.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract Cutaneous leishmaniasis is a disease caused by an intracellular protozoan parasite; Glucantime is a therapeutic option, although it is associated with cardiovascular alterations, the most frequent being the prolongation of the QTc interval, that occurs between 17.8% and 19% of patients. If this effect is not early recognized, it can cause a fatal arrhythmia due to torsade de pointes. The case of a 77-year-old patient who was receiving intramuscu lar glucantime as treatment for cutaneous leishmaniasis is presented, the patient was admitted with severe refractory hypokalemia and episodes of torsade de pointes; subsequently, presented ventricular fibrillation that did not respond to defibrillation and resuscitation. The alterations in cardiac repolarization produced by this medicine are considered secondary to the accumulation of pentavalent and trivalent compounds in the myocardium. There is no specific treatment for this situation, but supportive manage ment should always be performed, avoid drugs that prolong the QT inter val, normalize potassium and magnesium levels, raise the heart rate with isoproterenol and implant transvenous pacemaker to achieve over-stimulation and reduction of refractory periods.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Síndrome de QT largo]]></kwd>
<kwd lng="es"><![CDATA[Taquicardia]]></kwd>
<kwd lng="es"><![CDATA[Torsade de pointes]]></kwd>
<kwd lng="es"><![CDATA[Glu cantime]]></kwd>
<kwd lng="es"><![CDATA[Eventos adversos cardiovasculares mayores]]></kwd>
<kwd lng="en"><![CDATA[Long-QT syndrome]]></kwd>
<kwd lng="en"><![CDATA[Tachycardia]]></kwd>
<kwd lng="en"><![CDATA[Torsade de pointes]]></kwd>
<kwd lng="en"><![CDATA[Glucantime]]></kwd>
<kwd lng="en"><![CDATA[Major cardiovascular events]]></kwd>
</kwd-group>
</article-meta>
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