Annals of emergency medicine
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Comment Review Comparative Study
Disease control and crash injury-modifying host risk factors.
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We report the case of a 49-year-old man in whom a diagnosis of Brugada syndrome was made after he presented to the emergency department for evaluation of a syncopal episode. The diagnosis was made by ECG changes, after the characteristic findings of peculiar downsloping ST-segment elevation in leads V(1) and V(2) and QRS morphology resembling a right bundle branch block were identified. Emergency physician recognition of this syndrome and its ECG findings is essential, because without treatment the incidence of sudden cardiac death in these patients is high.
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Glyburide, a second-generation sulfonylurea hypoglycemic agent, is metabolized by the P-450 hepatic enzyme system. Ciprofloxacin, a widely used quinolone antibiotic, is a recognized P-450 enzyme inhibitor. ⋯ We present a case of hypoglycemia and an elevated serum glyburide level after 1 week of ciprofloxacin use in a patient receiving long-term glyburide therapy. Clinicians should consider this potential interaction in patients taking glyburide who require antibiotic therapy.