A case of demand ischemia from phendimetrazine
© Landau et al; licensee BioMed Central Ltd. 2008
Received: 26 June 2008
Accepted: 18 August 2008
Published: 18 August 2008
Phendimetrazine is a medication currently being used to help patients with weight loss. It shares a chemical structure with amphetamines. As such, it shares some of the same toxicities, which can include cardiac toxicity. This case highlights this principle.
a 54 year old Caucasian female presented to our urgent care facility with complaints of chest pains and other symptoms suggestive of acute coronary syndrome. Ultimately, she was transferred to the emergency room. After evaluation there, it appeared she was having demand ischemia from prescription diet pills
This case report demonstrates the potential dangers of amphetamine based diet pills. There have been other cases of cardiomyopathies related to phendimetrazine, but it is something that is rarely recognized in an outpatient setting. A case such as this demonstrates the importance of obtaining a careful medication history in all patients and in recognizing diet pills with an amphetamine base can cause cardiac toxicity.
Phendimetrazine is a medication currently being used for weight loss, with potential for illicit use. It has a similar chemical composition of amphetamines, which is thought to account for its clinical actions . Amphetamines are well recognized as an etiology of cardiac ischemia, however phendimetrazine is more rarely described in the literature as causing cardiac events. [2, 3]. Acute effects include hyperpyrexia, mydriasis, chest pain, arrhytmias, delirium, and, rhabdomylosis, among others . Long term use has been associated with dilated cardiomyopathies, some of which have resolved with discontinuation of the medication . In this particular case, it appears she may have developed a demand ischemia from the medication. It is not known how much of the drug she was taking. Initially, she was resistant to accepting that phendimetrazine could induce side effects, and there was suspicion that she could have been taking more of the drug that recommended. In addition, she was not prescribed the medication and would not admit to where she obtained it. As the public seems to have more focus on using medications to induce weight loss, this may be a more recognized complication and heart conditions should likely be monitored prior to starting amphetamine based weight loss pills.
Due to potentially detrimental effects of this medication, phendimetrazine should be used cautiously in many situations. As it shares its chemical structure with amphetamines, it also shares many of the side effects and the potential for abuse/addiction. There have been other reports in literature describing adverse outcomes from phendimetrazine as well as other weight loss medications. Therefore, cautious use is warranted.
Written informed consent was obtained from the patient for publication purposes. A copy can be obtained if requested by the Editor in Chief of this journal.
Acute Coronary Syndrome.
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