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QT prolonging medication

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https://www.readbyqxmd.com/read/29739726/new-onset-seizures-in-a-patient-with-long-qt-syndrome-lqts2-and-a-pathogenic-carboxyl-terminus-frameshift-variant-of-the-kcnh2-gene
#1
Katherine Zarroli, Henry Querfurth
In patients with Long QT Syndrome (LQTS), mutations in the potassium channel KCNH2 gene increase seizure susceptibility with missense mutations involving the pore region of the gene acting as a positive predictor of seizures. Seizures are less commonly reported in patients with carboxyl (C')-terminus mutations. This case report describes a young man who presented with syncope followed by a first seizure and was found to have LQTS caused by a pathogenic carboxyl-terminus deletion/frameshifting mutation of the KCNH2 gene...
May 5, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29672845/drug-induced-proarrhythmia-and-torsade-de-pointes-a-primer-for-students-and-practitioners-of-medicine-and-pharmacy
#2
REVIEW
J Rick Turner, Ignacio Rodriguez, Emily Mantovani, Gary Gintant, Peter R Kowey, Ralph J Klotzbaugh, Krishna Prasad, Philip T Sager, Norman Stockbridge, Colette Strnadova
Multiple marketing withdrawals due to proarrhythmic concerns occurred in the United States, Canada, and the United Kingdom in the late 1980s to early 2000s. This primer reviews the clinical implications of a drug's identified proarrhythmic liability, the issues associated with these safety-related withdrawals, and the actions taken by the International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH) and by regulatory agencies in terms of changing drug development practices and introducing new nonclinical and clinical tests to asses proarrhythmic liability...
April 19, 2018: Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29651961/the-benefit-of-prescribing-vitamin-d-as-add-on-therapy-on-the-electrocardiographic-changes-in-epileptic-patients
#3
Marwan S M Al-Nimer
BACKGROUND: Epileptic children and adolescent have a significantly low serum level of vitamin D due to the effect of antiepileptic drugs on the vitamin D metabolism. Those patients are at risk of cardiovascular events. OBJECTIVE: This study aimed to show that epileptic patients who treated with antiepileptic drugs supplemented with vitamin D are free from the electrocardiograph changes compared with those treated with antiepileptic drugs. METHOD: This cross-sectional study included, 121 epileptic patients aged < 18 years of both genders with a history of idiopathic generalized tonic clonic seizure...
April 12, 2018: Current Clinical Pharmacology
https://www.readbyqxmd.com/read/29642718/psychotropic-pharmacotherapy-associated-with-qt-prolongation-among-veterans-with-posttraumatic-stress-disorder
#4
Eileen M Stock, John E Zeber, Catherine J McNeal, Javier E Banchs, Laurel A Copeland
BACKGROUND: In 2012, the Food and Drug Administration issued Drug Safety Communications on several drugs associated with QT prolongation and fatal ventricular arrhythmias. Among these was citalopram, a selective serotonin reuptake inhibitor (SSRI) approved for depression and commonly used for posttraumatic stress disorder (PTSD). Evaluation of the risk for QT prolongation among other psychotropic drugs for individuals with PTSD remains limited. OBJECTIVE: Explore psychotropic drugs associated with QT prolongation among veterans with PTSD...
April 1, 2018: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/29605013/dofetilide-dose-reductions-and-discontinuations-in-women-compared-with-men
#5
Sean D Pokorney, Debbie C Yen, Kristen B Campbell, Nancy M Allen LaPointe, Shubin Sheng, Laine Thomas, Tristram D Bahnson, James P Daubert, Jonathan P Picini, Kevin P Jackson, Kevin L Thomas, Sana M Al-Khatib
BACKGROUND: Compared with men, women have longer corrected QT (QTc) intervals, lower clearance of dofetilide, and higher rates of drug-induced torsades de pointes, but the dofetilide dosing algorithm is the same for men and women. OBJECTIVE: The purpose of this study was to evaluate the tolerability of the 500 μg twice daily dose of dofetilide for men and women. METHODS: Men and women admitted to Duke University Medical Center (January 1, 2006, to October 19, 2012) for the initiation of dofetilide 500 μg twice daily were matched 1:1 on age and estimated creatinine clearance...
April 2018: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/29531576/quantitative-assessment-of-the-physiological-parameters-influencing-qt-interval-response-to-medication-application-of-computational-intelligence-tools
#6
Sebastian Polak, Barbara Wiśniowska, Aleksander Mendyk, Adam Pacławski, Jakub Szlęk
Human heart electrophysiology is complex biological phenomenon, which is indirectly assessed by the measured ECG signal. ECG trace is further analyzed to derive interpretable surrogates including QT interval, QRS complex, PR interval, and T wave morphology. QT interval and its modification are the most commonly used surrogates of the drug triggered arrhythmia, but it is known that the QT interval itself is determined by other nondrug related parameters, physiological and pathological. In the current study, we used the computational intelligence algorithms to analyze correlations between various simulated physiological parameters and QT interval...
2018: Computational and Mathematical Methods in Medicine
https://www.readbyqxmd.com/read/29511826/efficacy-and-safety-of-amantadine-for-the-treatment-of-l-dopa-induced-dyskinesia
#7
REVIEW
Santiago Perez-Lloret, Olivier Rascol
L-DOPA induced dyskinesias (LIDs) may affect up to 40% of Parkinson's disease (PD) and impact negatively health-related quality of life. Amantadine has demonstrated significant antidyskinetic effects in animal PD models and in randomized double-blind placebo-controlled trials (RCTs) in patients with PD. These effects are thought to be related to the blockade of NMDA receptors modulating cortico-striatal glutamatergic-dopaminergic interactions involved in the genesis of LIDs. There are three pharmaceutical forms of amantadine currently available in the market: an oral immediate-release (IR) formulation, which is widely available; an extended-release (ER) formulation (ADS-5102) which has been recently developed and approved by the FDA; and an intravenous infusion (IV) solution, which is not commonly used in clinical practice...
March 7, 2018: Journal of Neural Transmission
https://www.readbyqxmd.com/read/29483798/electrocardiographic-changes-in-children-with-diabetic-ketoacidosis-and-ketosis
#8
Deniz Aygün, Fatih Aygün, Kemal Nişli, Firdevs Baş, Agop Çıtak
Aim: We aimed to study electrocardiographic changes in children with diabetic ketoacidosis and ketosis and to evaluate the relation of the changes with serum electrolyte levels and ketosis. Material and Methods: This study was performed in Istanbul Medical Faculty, Pediatric Emergency and Intensive Care Department between May 2008 and May 2009. The electrocardiographic parameters and QT length of children with diabetic ketoacidosis and ketosis were evaluated at diagnosis and after the treatment...
December 2017: Türk Pediatri Arşivi
https://www.readbyqxmd.com/read/29473523/drug-induced-qt-interval-prolongation-in-the-intensive-care-unit
#9
Cecilia Villa Etchegoyen, Guillermo Alberto Keller, Sebastian Mrad, Sixuan Cheng, Guillermo Di Girolamo
BACKGROUND: The most common acquired cause of Long QT syndrome (LQTS) is drug induced QT interval prolongation. It is an electrophysiological entity, which is characterized by an extended duration of the ventricular repolarization. Reflected as a prolonged QT interval in a surface ECG, this syndrome increases the risk for polymorphic ventricular tachycardia (Torsade de Pointes) and sudden death. METHOD: Bibliographic databases as MEDLINE and EMBASE, reports and drug alerts from several regulatory agencies (FDA, EMEA, ANMAT) and drug safety guides (ICH S7B, ICH E14) were consulted to prepare this article...
2017: Current Clinical Pharmacology
https://www.readbyqxmd.com/read/29458991/prevalence-of-the-risk-factors-for-qt-prolongation-and-associated-drug-drug-interactions-in-a-cohort-of-medical-inpatients
#10
Qasim Khan, Mohammad Ismail, Iqbal Haider, Zahid Ali
BACKGROUND/PURPOSE: Medical inpatients are at increased risk of QT interval prolongation due to multiple risk actors and QT prolonging drugs. This study aimed to identify the prevalence of risk factors for QT prolongation; QT prolonging medications; associated drug-drug interactions (QT-DDIs); their predictors; and TdP (torsades de pointes) risks of drugs. METHODS: This cohort study was carried out in medical wards of two tertiary hospitals in Khyber Pakhtunkhwa, Pakistan...
February 16, 2018: Journal of the Formosan Medical Association, Taiwan Yi Zhi
https://www.readbyqxmd.com/read/29441683/cardiovascular-safety-of-prokinetic-agents-a-focus-on-drug-induced-arrhythmias
#11
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/29431662/classification-and-reporting-of-potentially-proarrhythmic-common-genetic-variation-in-long-qt-syndrome-genetic-testing
#12
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/29430560/epilepsy-is-associated-with-ventricular-alterations-following-convulsive-status-epilepticus-in-children
#13
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/29410000/meta-regression-relationship-between-antipsychotic-receptor-binding-profiles-and-side-effects
#14
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...
June 8, 2018: Progress in Neuro-psychopharmacology & Biological Psychiatry
https://www.readbyqxmd.com/read/29399762/the-effects-of-supraphysiological-estrogen-levels-on-ventricular-repolarization-parameters
#15
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/29372020/pain-medication-and-long-qt-syndrome
#16
REVIEW
Christoph Klivinyi, Helmar Bornemann-Cimenti
Long QT syndrome is a cardiac repolarization disorder and is associated with an increased risk of torsades de pointes. The acquired form is most often attributable to administration of specific medications and/or electrolyte imbalance. This review provides insights into the risk for QT prolongation associated with drugs frequently used in the treatment of chronic pain. In the field of pain medicine all the major drug classes (i.e. NSAIDs, opioids, anticonvulsive and antidepressant drugs, cannabinoids, muscle relaxants) contain agents that increase the risk of QT prolongation...
January 2018: Korean Journal of Pain
https://www.readbyqxmd.com/read/29349356/qt-interval-prolongation-due-to-medication-found-in-the-preoperative-evaluation
#17
Mika Seto, Sayo Koga, Ryosuke Kita, Toshihiro Kikuta
QT prolongation is an electrocardiographic change that can lead to lethal arrhythmia. Acquired QT prolongation is known to be caused by drugs and electrolyte abnormalities. We report three cases in which the prolonged QT interval was improved at the time of operation by briefly discontinuing the drugs suspected to have caused the QT prolongation observed on preoperative electrocardiography. The QTc of cases 1, 2, and 3 improved from 518 to 429 ms, 463 to 441 ms, and 473 to 443 ms on discontinuing the use of a gastrointestinal prokinetic agent, a proton pump inhibitor, and a molecular targeted drug, respectively...
December 2017: Journal of Dental Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29317399/effect-of-a-single-dose-of-i-v-ondansetron-on-qtc-interval-in-emergency-department-patients
#18
Kai Li, Kathy Vo, Byron K Lee, Newton Addo, Zlatan Coralic
PURPOSE: Results of a study to determine whether i.v. administration of a single dose of 4 mg of ondansetron was associated with QT interval prolongation in emergency department (ED) patients are reported. METHODS: In a prospective observational study conducted at an urban academic medical center ED, a convenience sample of adult ED patients treated with ondansetron 4 mg i.v. were enrolled. A 12-lead electrocardiogram (ECG) was obtained immediately before and 5 minutes after ondansetron administration...
March 1, 2018: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/29298624/approach-to-initiating-qt-prolonging-oncology-drugs-in-the-ambulatory-setting
#19
Mário L de Lemos, Carrie Kung, Victoria Kletas, Nadine Badry, Isabell Kang
Since the introduction of regulatory drug approval guidance on the evaluation of QT interval prolongation, an increasing number of drug monographs has included cautions on the risk of QT prolongation. For example, QT prolongation is mentioned in the Canadian product monographs of 29 drugs commonly seen in oncology practice. This presents two major challenges. First, most guidelines and risk predictive tools for QT prolongation have been developed for hospitalized patients in acute care settings. In contrast, most QT-prolonging oncology drugs are used in medically stable patients in the ambulatory setting...
January 1, 2018: Journal of Oncology Pharmacy Practice
https://www.readbyqxmd.com/read/29275963/qt-prolongation-torsades-de-pointes-and-psychotropic-medications-a-5-year-update
#20
REVIEW
Scott R Beach, Christopher M Celano, Alan M Sugrue, Caitlin Adams, Michael J Ackerman, Peter A Noseworthy, Jeff C Huffman
BACKGROUND: Some psychotropic medications have been associated with prolongation of the QT interval and QT prolongation, especially in those with medical illness, and are linked to lethal ventricular arrhythmias, such as Torsades de Pointes (TdP). In 2013, we published a review of QT prolongation, TdP, and psychotropic medications. OBJECTIVE: We provide an update over the past 5 years on the specific concerns most relevant to clinicians who see medically ill patients...
March 2018: Psychosomatics
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