Outcomes of extra-dose exposures of Vaughan Williams Class I or III antidysrhythmic medications
Bibliographic record
Abstract
INTRODUCTION: Antidysrhythmic medications are commonly prescribed, but there is little information on the incidence of adverse effects following an inadvertent extra dose of these medications. This poses a challenge to poison centers when trying to decide which patients need to be sent to a healthcare facility for monitoring. METHODS: A retrospective data review of cases reported to a regional poison center between January 1, 2012 and December 31, 2022 was performed. Cases were included if the exposure was a double dose or less of the patient's own antidysrhythmic medication, the exposure was unintentional or a result of therapeutic error, and the antidysrhythmic(s) belonged to Vaughan Williams Class I or III. Cases were included even if other medications were included in the therapeutic error. Descriptive data were collected on cases meeting the inclusion criteria. RESULTS: One hundred and sixty-two exposures were included. Of these, only 49 were monitored in a healthcare facility for which coded outcomes were available. Of these, the majority had no or minor effects (83.7%). Two of the exposures developed hypotension, but both also involved either a beta-adrenoceptor blocking drug or a calcium-channel blocker. Of the 25 cases that only included an antidysrhythmic, adverse effects were even less common, with 92.0% having no or only minor effects. DISCUSSION: In this small cohort, adverse events were uncommon with inadvertent extra dose antidysrhythmic exposures. However, serious outcomes have been reported in other studies. It appears adverse events are less common if the extra dose exposure does not involve other cardioactive medications. CONCLUSIONS: Extra-dose exposures of some antidysrhythmics belonging to Vaughan Williams Class I or III were generally well tolerated, but more data are needed to determine whether certain patients can be safely monitored at home. For example, only three cases involved Class IA drugs. Based on our findings, patients who reportedly ingest an extra dose of an antidysrhythmic plus another cardioactive medication should be evaluated at a healthcare facility.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".