Clinical-pharmacological aspects of the safe use of medicines, causing prolongation of QT interval
Abstract
Specific aspects of manifestation of prolonged QT syndrome, developed during the use of drugs belonging to different pharmacological groups are discussed. It analyses data on dangerous combinations of drugs that prolong the QT interval. The combination of drugs with the possible and conditional risk of QT interval prolongation and other drugs, which can influence the activity of metabolizing isoenzymes cytochrome P450, require special care from physicians, especially in elderly patients. Taking into account the possibilities of QT prolongation due to drug interactions it is recommended to avoid the use of potentially unsafe drug combinations.
About the Authors
O. A. Demidova
Scientific Centre for Expert Evaluation of Medicinal Products
Russian Federation
Russian Federation
E. V. Shikh
Scientific Centre for Expert Evaluation of Medicinal Products; I. M. Sechenov First Moscow State Medical University
Russian Federation
Russian Federation
A. D. Ismagilov
I. M. Sechenov First Moscow State Medical University
Russian Federation
Russian Federation
Zh. M. Sizova
I. M. Sechenov First Moscow State Medical University
Russian Federation
Russian Federation
References
1. Kamm AJ, Lusher TF, Serruis PV. Cardiovascular disease. M.: Geotar-Media; 2011.
2. Schwartz PJ, Spazzolini C, Crotti L. et al. The Jervel and Lange Nielsen Sundrome: natural history, molecular basis and clinical putcome. Circulation 2006; 113: 783–790.
3. Combined List of Drugs that Prolong QT and/or cause Torsades de Pointes (TdP). Available from: https://www.crediblemeds.org.
4. Limankina IN. Voprosy kardioaritmologu. Sindrom udlinennogo QT. [Internet]. 2017 [cited 2017 Feb 14]. Available from : http://medlinks.ru (in Russian).
5. Ushkalova EA. Medicines and QT interval. Farmateka 2001; (7): 45–53 (in Russian).
6. Dresser GK, Spence JD, Bailey DG. Pharmacokinetic- pharmacodynamic consequences and clinical relevance of cytochrome P-450 3A4 inhibition. Clin. Pharmacokinet. 2000; 38(1): 41–57.
7. Marinucci P. Grapefruit juice is source of potentially life threatening adverse drug reactions. Br. Med J. 2001; 322: 46.
8. Iannini P. Prolongation of QT interval is probably a class effect of fluoroquinolones. Br. Med. J. 2001; 244: 22.
9. Iannini PB, Circiumaru I, Byazrova E, Doddamani S, Kramer H, QTc prolongation associated with levofloxacin. In: Program and abstracts of the 40th Interscience Conference on Antimicrobiol Agents and Chemotherapy, Toronto.
10. Qwens RC. Risk assessment for antimicrobial agent induced QTc interval prolongation and torsades de points. Pharmacotherapy 2001; 21: 310–9.
11. Gury C, Canceil O, Iaria P. Antipsychotic drugs and cardiovascular safety: current studies of prolonged QT interval and risk of ventricular arrhythmia. Encephale 2000; 26: 62–72.
12. Limankina IN. Long QT Syndrome and safety problems of psychophamacotherapy. Vestnik aritmologii 2008; 52: 66–71 (in Russian).
13. Bordin DS. Safety of treatment as a criterion for choosing a proton pump inhibitor for a patient with gastroesophageal reflux disease. Consilium Medicum 2010; 12; 8 (in Russian).
14. Long QT Syndrome. Symptoms and signs. Available from: http://www.medmoon.ru/bolezni/bol43l.html (in Russian).
15. Romanov B. K. Kal’tsievaya regulyatsiya aktivnosti lizosomal’nykh fermentov miokarda. Biomedical chemistry 2005; 51(6): 634–642 (in Russian).
16. Arsentieva RH. Long QT syndrome. Vestnik sovremennoy klinicheskoy meditsiny 2012; 5(3): 72–3 (in Russian).
17. Pickham D, Helfenbein E, Shinn JA, Chan G, Funk M, Weinacker A, et al. High prevalence of corrected QT interval prolongation in acutely ill patients is associated with mortality: Results of the QT in Practice (QTIP) Study. Critical Care Medicine 2012; 2(40): 394–9.
18. Shikh EV, Ismagilov AD, Sizova ZhM, Demidova OA, Safety of combination pharmacotherapy in elderly patients. The Bulletin of the Scientific Centre for Expert Evaluation of Medicinal Products 2017; 7(1), 47–54 (in Russian).
19. Mizusawa Y,Wilde AA. QT Prolongation and Mortality in Hospital Settings: Identifying Patients at High Risk. Mayo Clin Proc. 2013; 88(4): 309–11.
20. Furman NV, Shmatova SS. Clinical significiance of drug-induced intervals QT and QTñ prolongation. Ratcionalnaya farmakoterapiya v kardologii 2013; 9(3): 311–5 (in Russian).
Review
For citations:
Demidova O.A., Shikh E.V., Ismagilov A.D., Sizova Zh.M. Clinical-pharmacological aspects of the safe use of medicines, causing prolongation of QT interval. Safety and Risk of Pharmacotherapy. 2017;5(3):117-125. (In Russ.)
Views:
1642
Email this article 