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https://www.readbyqxmd.com/read/29455270/ventricular-tachycardia-triggered-by-loperamide-and-famotidine-abuse
#1
Timothy R Larsen, Jedediah McMunn, Hala Ahmad, Soufian T AlMahameed
A 32-year-old male developed recurrent ventricular tachycardia after taking mega doses of loperamide and famotidine in order to experience an opiate-like euphoric effect. He was taking up to 200 mg of loperamide and multiple doses of famotidine each day. He developed palpitations and syncope. Electrocardiography demonstrated ventricular tachycardia and QT interval prolongation (corrected QT interval was 597 ms). He was diagnosed with loperamide-induced QT prolongation resulting in incessant ventricular tachycardia...
February 17, 2018: Drug Safety—Case Reports
https://www.readbyqxmd.com/read/29441683/cardiovascular-safety-of-prokinetic-agents-a-focus-on-drug-induced-arrhythmias
#2
REVIEW
J R Giudicessi, M J Ackerman, M Camilleri
BACKGROUND: Gastrointestinal sensorimotor dysfunction underlies a wide range of esophageal, gastric, and intestinal motility and functional disorders that collectively constitute nearly half of all referrals to gastroenterologists. As a result, substantial effort has been dedicated toward the development of prokinetic agents intended to augment or restore normal gastrointestinal motility. However, the use of several clinically efficacious gastroprokinetic agents, such as cisapride, domperidone, erythromycin, and tegaserod, is associated with unfavorable cardiovascular safety profiles, leading to restrictions in their use...
February 14, 2018: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/29440923/managing-hyperparathyroidism-in-hemodialysis-role-of-etelcalcetide
#3
REVIEW
Keith E Eidman, James B Wetmore
Secondary hyperparathyroidism (SHPT) is common in patients receiving maintenance hemodialysis and is associated with adverse outcomes. Currently, SHPT is managed by reducing circulating levels of phosphate with oral binders and parathyroid hormone (PTH) with vitamin D analogs and/or the calcimimetic cinacalcet. Etelcalcetide, a novel calcimimetic administered intravenously (IV) at the end of a hemodialysis treatment session, effectively reduces PTH in clinical trials when given thrice weekly. Additional clinical effects include reductions in circulating levels of phosphate and FGF-23 and an improved profile of markers of bone turnover...
2018: International Journal of Nephrology and Renovascular Disease
https://www.readbyqxmd.com/read/29436197/the-role-of-serotonin-in-ventricular-repolarization-in-pregnant-mice
#4
Shanyu Cui, Hyewon Park, Hyelim Park, Dasom Mun, Seung Hyun Lee, Hyoeun Kim, Nuri Yun, Hail Kim, Michael Kim, Hui Nam Pak, Moon Hyoung Lee, Boyoung Joung
PURPOSE: The mechanisms underlying repolarization abnormalities during pregnancy are not fully understood. Although maternal serotonin (5-hydroxytryptamine, 5-HT) production is an important determinant for normal fetal development in mice, its role in mothers remains unclear. We evaluated the role of serotonin in ventricular repolarization in mice hearts via 5Htr3 receptor (Htr3a) and investigated the mechanism of QT-prolongation during pregnancy. MATERIALS AND METHODS: We measured current amplitudes and the expression levels of voltage-gated K⁺ (Kv) channels in freshly-isolated left ventricular myocytes from wild-type non-pregnant (WT-NP), late-pregnant (WT-LP), and non-pregnant Htr3a homozygous knockout mice (Htr3a(-/-)-NP)...
March 2018: Yonsei Medical Journal
https://www.readbyqxmd.com/read/29433934/evidence-based-review-of-pharmacotherapy-for-acute-agitation-part-2-safety
#5
Leslie S Zun
BACKGROUND: The management of acute agitation in the emergency department often requires the administration of rapid-acting antipsychotic agents. However, there are few comparative studies and little guidance regarding the risks associated with use of such drugs in the acute setting. OBJECTIVE: This structured evidence-based review compared the safety of antipsychotic pharmacotherapies for acute agitation using data from randomized controlled trials identified by a literature search of the PubMed database...
February 9, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29431731/physiological-genomics-identifies-genetic-modifiers-of-long-qt-syndrome-type-2-severity
#6
Sam Chai, Xiaoping Wan, Angelina Ramirez-Navarro, Paul J Tesar, Elizabeth S Kaufman, Eckhard Ficker, Alfred L George, Isabelle Deschênes
Congenital long QT syndrome (LQTS) is an inherited channelopathy associated with life-threatening arrhythmias. LQTS type 2 (LQT2) is caused by mutations in KCNH2, which encodes the potassium channel hERG. We hypothesized that modifier genes are partly responsible for the variable phenotype severity observed in some LQT2 families. Here, we identified contributors to variable expressivity in an LQT2 family by using induced pluripotent stem cell-derived cardiomyocytes (iPSC-CMs) and whole exome sequencing in a synergistic manner...
February 12, 2018: Journal of Clinical Investigation
https://www.readbyqxmd.com/read/29431662/classification-and-reporting-of-potentially-proarrhythmic-common-genetic-variation-in-long-qt-syndrome-genetic-testing
#7
REVIEW
John R Giudicessi, Dan M Roden, Arthur A M Wilde, Michael J Ackerman
The acquired and congenital forms of long QT syndrome represent 2 distinct but clinically and genetically intertwined disorders of cardiac repolarization characterized by the shared final common pathway of QT interval prolongation and risk of potentially life-threatening arrhythmias. Over the past 2 decades, our understanding of the spectrum of genetic variation that (1) perturbs the function of cardiac ion channel macromolecular complexes and intracellular calcium-handling proteins, (2) underlies acquired/congenital long QT syndrome susceptibility, and (3) serves as a determinant of QT interval duration in the general population has grown exponentially...
February 6, 2018: Circulation
https://www.readbyqxmd.com/read/29431613/mhra-quinine-qt-prolonging-effects-and-drug-interactions
#8
(no author information available yet)
No abstract text is available yet for this article.
February 5, 2018: Drug and Therapeutics Bulletin
https://www.readbyqxmd.com/read/29430560/epilepsy-is-associated-with-ventricular-alterations-following-convulsive-status-epilepticus-in-children
#9
Wail Ali, Beth A Bubolz, Linh Nguyen, Danny Castro, Jorge Coss-Bu, Michael M Quach, Curtis E Kennedy, Anne E Anderson, Yi-Chen Lai
Objective: Convulsive status epilepticus can exert profound cardiovascular effects in adults including ventricular depolarization-repolarization abnormalities. Whether status epilepticus adversely affects ventricular electrical properties in children is less understood. Therefore, we sought to characterize ventricular alterations and the associated clinical factors in children following convulsive status epilepticus. Methods: We conducted a 2-year retrospective, case-control study...
December 2017: Epilepsia Open
https://www.readbyqxmd.com/read/29428463/cardiac-repolarization-evolves-differently-during-the-course-of-benign-and-disabling-multiple-sclerosis
#10
Alma Mikkola, Aku Ojanen, Juha Ek Hartikainen, Anne M Remes, Sakari Simula
BACKGROUND: Cardiac repolarization is modulated by the autonomic nervous system. Even though multiple sclerosis associates with prolonged cardiac repolarization the physiology responsible for the phenomenon remains unknown. OBJECTIVE: To study in longitudinal setting whether the patients with confirmed benign and disabling outcome of relapsing-remitting multiple sclerosis (RRMS) differ in regard to changes of cardiac repolarization. METHODS: Total of 43 patients, 26% with benign (EDSS ≤2 at least 10y after onset symptom) and 74% with disabling (EDSS >2 at least 10y after onset symptom) RRMS, having 12-lead electrocardiogram (ECG) recorded at the time of onset symptom (ECG1) and for follow-up (ECG2), were studied...
February 1, 2018: Multiple Sclerosis and related Disorders
https://www.readbyqxmd.com/read/29424967/predicting-drug-induced-arrhythmias-by-multiscale-modeling
#11
F Sahli Costabal, J Yao, E Kuhl
Drugs often have undesired side effects. In the heart, they can induce lethal arrhythmias such as torsades de pointes. The risk evaluation of a new compound is costly and can take a long time, which often hinders the development of new drugs. Here we establish a high resolution, multiscale computational model to quickly assess the cardiac toxicity of new and existing drugs. The input of the model is the drug-specific current block from single cell electrophysiology; the output is the spatio-temporal activation profile and the associated electrocardiogram...
February 9, 2018: International Journal for Numerical Methods in Biomedical Engineering
https://www.readbyqxmd.com/read/29416210/assesment-of-rhythm-disorders-in-classical-and-nonclassical-mitral-valve-prolapse
#12
Enisa Hodzic
Introduction: Mitral Valve Prolapse (MVP) is the most common cardiac valve pathology of to day. Aim of article was to identify the types and frequency of potentially malignant arrhythmia and atrial brillation in patients with MVP, to determine the differences in these arrhythmias between classical and non-classical MVP, to evaluate the correlation of potentially malignant arrhythmia and atrial fibrillation with MVP with possible clinical complications of arrhythmogenic sudden cardiac death and potential risk of thromboembolic vascular incident...
February 2018: Medical Archives
https://www.readbyqxmd.com/read/29415258/a-long-term-open-label-study-to-evaluate-the-safety-and-tolerability-of-brexpiprazole-as-maintenance-treatment-in-adults-with-schizophrenia
#13
Andy Forbes, Mary Hobart, John Ouyang, Lily Shi, Stephanie Pfister, Mika Hakala
Background: Brexpiprazole is a serotonin-dopamine activity modulator with efficacy in acute schizophrenia and relapse prevention. The aim of this Phase 3, multicenter study was to assess the long-term safety, tolerability, and efficacy of treatment with brexpiprazole flexible-dose 1-4 mg/day. Methods: Patients rolled over into this 52-week open-label study (amended to 26 weeks towards the end) from three randomized, double-blind, placebo-controlled Phase 3 studies...
February 3, 2018: International Journal of Neuropsychopharmacology
https://www.readbyqxmd.com/read/29413968/current-perspective-osimertinib-induced-qt-prolongation-new-drugs-with-new-side-effects-need-careful-patient-monitoring
#14
Mart Schiefer, Lizza E L Hendriks, Trang Dinh, Ulrich Lalji, Anne-Marie C Dingemans
An increasing number of tyrosine kinase inhibitors (TKIs) are available for the treatment of non-small cell lung cancer (NSCLC). QT prolongation is one of the known, but relatively rare, adverse events of several TKIs (e.g. osimertinib, crizotinib, ceritinib). Screening for QT prolongation in (high risk) patients is advised for these TKIs. When a QT prolongation develops, the physician is challenged with the question whether to (permanently) discontinue the TKI. In this perspective, we report on a patient who developed a grade III QT prolongation during osimertinib (a third-generation epidermal growth factor receptor [EGFR]-TKI) treatment...
March 2018: European Journal of Cancer
https://www.readbyqxmd.com/read/29410000/meta-regression-relationship-between-antipsychotic-receptor-binding-profiles-and-side-effects
#15
Baris Olten, Michael H Bloch
Our objective was to examine the association between antipsychotic receptor binding profiles and the magnitude of common side-effects. We used regression analysis to examine the association between the receptor binding affinities of antipsychotic agents (log Ki) and degree of specific antipsychotic side-effects. Data on magnitude of weight gain, prolactin increase and QTc prolongation (in Standardized Mean Difference) and risk of sedation and extrapyramidal symptoms (in Odds Ratio) between individual antipsychotic medications as compared to placebo was based on a recent network meta-analysis examining the treatment of schizophrenia...
February 1, 2018: Progress in Neuro-psychopharmacology & Biological Psychiatry
https://www.readbyqxmd.com/read/29408217/autonomic-conflict-exacerbates-long-qt-associated-ventricular-arrhythmia
#16
James Winter, Michael Tipton, Michael J Shattock
This study tested the hypothesis that concomitant sympathetic and parasympathetic stimulation ("autonomic conflict") may act as a trigger for arrhythmia in long QT syndrome (LQTS). Studies were performed in isolated innervated rabbit hearts treated with clofilium (100 nmol/L); a potassium channel blocker. The influence of vagus nerve stimulation (VNS) on spontaneous ventricular arrhythmia was assessed in the absence/presence of sustained noradrenaline perfusion (100 nmol/L) and with sudden adrenergic stress (injections of noradrenaline into the perfusion line)...
February 2, 2018: Journal of Molecular and Cellular Cardiology
https://www.readbyqxmd.com/read/29407091/estradiol-protection-against-toxic-effects-of-catecholamine-on-electrical-properties-in-human-induced-pluripotent-stem-cell-derived-cardiomyocytes
#17
Ibrahim El-Battrawy, Zhihan Zhao, Huan Lan, Jan-Dierk Schünemann, Katherine Sattler, Fanis Buljubasic, Bence Patocskai, Xin Li, Gökhan Yücel, Siegfried Lang, Daniel Nowak, Lukas Cyganek, Karen Bieback, Jochen Utikal, Wolfram-Hubertus Zimmermann, Ursula Ravens, Thomas Wieland, Martin Borggrefe, Xiao-Bo Zhou, Ibrahim Akin
BACKGROUND AND PURPOSE: Previous studies revealed that Takotsubo cardiomyopathy (TTC), a transient disorder of ventricular dysfunction affecting predominantly postmenopausal women, is associated with acquired long QT syndrome and arrhythmias, but the exact pathophysiologic mechanism is unknown. Our aim is to investigate the electrophysiological mechanism for QT-prolongation in TTC-patients by using human induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs). METHODS: hiPSC-CMs, which were generated from human skin fibroblasts of three healthy donors, were treated by estradiol (10μM for one week) and a toxic concentration of isoprenaline (Iso, 1mM for 2h)...
March 1, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29399762/the-effects-of-supraphysiological-estrogen-levels-on-ventricular-repolarization-parameters
#18
Omer Yiginer, Mehmet Dogan, Ismet Gun, Huseyin Tayfun Kutlu, Gokhan Degirmencioglu, İlkin Guliyev, Alptug Tokatli, Fethi Kilicaslan
BACKGROUND: The frequency of arrhythmic death developing without a structural cardiac disease is higher in women. Also female gender is an independent risk factor regarding developing Torsades des Pointes. Several studies have been conducted on the effects of physiological and therapeutic sex hormones on cardiac conduction system. AIM: In this study we aim to examine the effect of hormonal changes occurring during in vitro fertilization treatment and especially supraphysiological E2 levels on ventricular repolarization parameters...
February 5, 2018: Kardiologia Polska
https://www.readbyqxmd.com/read/29395105/new-formula-for-defining-normal-and-prolonged-qt-in-patients-with-bundle-branch-block
#19
Lior Yankelson, Aviram Hochstadt, Ben Sadeh, Benley Pick, Ariel Finkelstein, Raphael Rosso, Sami Viskin
OBJECTIVES: To predict the QT interval in the presence of normal QRS for patients with left bundle branch block (LBBB). BACKGROUND: There is no acceptable method for simple and reliable QT correction for patients with bundle branch block (BBB). METHODS: We measured the QT interval in patients with new onset LBBB who had a recent electrocardiogram with narrow QRS for comparison. 48 patients who developed in-hospital LBBB were studied. Patients who had similar heart rate before and after LBBB were included...
January 30, 2018: Journal of Electrocardiology
https://www.readbyqxmd.com/read/29392451/phase-1-summary-of-plasma-concentration-qtc-analysis-for-idasanutlin-an-mdm2-antagonist-in-patients-with-advanced-solid-tumors-and-aml
#20
Steven Blotner, Lin-Chi Chen, Cristiano Ferlini, Jianguo Zhi
PURPOSE: Idasanutlin, a selective small-molecule MDM2 antagonist in phase 3 testing for refractory/relapsed AML, is a non-genotoxic oral p53 activator. The aim of this analysis is to examine the potential of idasanutlin to prolong the corrected QT (QTc) interval by evaluating the relationship between plasma idasanutlin concentration and QTc interval. METHOD: Intensive plasma concentration QTc interval data were collected at the same timepoints, from three idasanutlin (RO5503781) phase 1 studies in patients with solid tumors and AML...
February 1, 2018: Cancer Chemotherapy and Pharmacology
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