Current issue
Archive
About the Journal
About us
Aims and Scope
Indexing and Abstracting
Editorial Office
Open Access Policy
Publication Ethics
Contact
For Authors
Editorial Policy
Peer Review Policy
Manuscript Preparation Guidelines
Copyright & Licensing
Publication Fees
Fast-Track Paper Publication Option
Conflict Interest Guidance
Submit an Article
Special Issues
News & Editorials
“Fake,” “Predatory,” and “Pseudo” Journals: Charlatans Threatening Trust in Science
Shifting the Journal submission-review system to the Editorial System Manuscript December 27, 2017.
ORIGINAL ARTICLE
Prolongation of the QT interval in patients with coronary heart disease as consequence of drug-drug interactions on metabolic rate
1
Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Russia
Publication date: 2018-07-11
Electron J Gen Med 2018;15(4):em68
KEYWORDS
coronary heart diseasesafety of concomitant administrationQT intervalpolymorphic ventricular tachycardiasudden deathdrug-drug interactionsmetabolism
ABSTRACT
Objective:
Prolongation of the QT interval in patients with coronary heart disease (CAD) is a risk factor of polymorphic ventricular tachycardia (PVT) and as consequence, the sudden death. Drug-drug interactions (DDI) on metabolic rate involving cytochrome P-450 (CYP) is the one of the major cause of Long QT Syndrome (LQTS). The aim of the present study was to improve the safety of combined pharmacotherapy when using drugs that affect the QT interval.
Method and Results:
Medication occurrence of potential dangerous combination of medicines that are affected on QT interval duration in patients with CAD are researched (outpatient medical records (patient history) analysis). Clinical relevance of DDI, which are associated with changes in CYP enzyme activity, categorized by drugs.com Medication Guide. Finding potential dangerous combination of medicines that are affected on QT interval duration were administered to patients with CAD in 3.6% cases in outpatient clinical practice. The most often prescribed combination of drugs is amiodarone and torasemide (13.3% evidence of all concomitant administration that are leading to QT prolongation). The potential mechanism of Amiodarone and Torasemide interaction on metabolic rate that are leading to QT prolongation are competitive substrates CYP 2C8 and a result of inhibited CYP 2C9 by amiodarone.
Conclusion:
Ability to predict the prolongation of the QT interval caused by DDI on metabolic rate make possible to improve the safety concomitant administration to patients with CAD.
Prolongation of the QT interval in patients with coronary heart disease (CAD) is a risk factor of polymorphic ventricular tachycardia (PVT) and as consequence, the sudden death. Drug-drug interactions (DDI) on metabolic rate involving cytochrome P-450 (CYP) is the one of the major cause of Long QT Syndrome (LQTS). The aim of the present study was to improve the safety of combined pharmacotherapy when using drugs that affect the QT interval.
Method and Results:
Medication occurrence of potential dangerous combination of medicines that are affected on QT interval duration in patients with CAD are researched (outpatient medical records (patient history) analysis). Clinical relevance of DDI, which are associated with changes in CYP enzyme activity, categorized by drugs.com Medication Guide. Finding potential dangerous combination of medicines that are affected on QT interval duration were administered to patients with CAD in 3.6% cases in outpatient clinical practice. The most often prescribed combination of drugs is amiodarone and torasemide (13.3% evidence of all concomitant administration that are leading to QT prolongation). The potential mechanism of Amiodarone and Torasemide interaction on metabolic rate that are leading to QT prolongation are competitive substrates CYP 2C8 and a result of inhibited CYP 2C9 by amiodarone.
Conclusion:
Ability to predict the prolongation of the QT interval caused by DDI on metabolic rate make possible to improve the safety concomitant administration to patients with CAD.
REFERENCES (25)
1.
Pickham D, Helfenbein E, Shinn JA. 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. https://doi.org/10.1097/CCM.0b....
2.
Isbister GK, Page CB. Drug induced QT prolongation: the measurement and assessment of the QT interval in clinical practice. British journal of clinical pharmacology. 2013;76(1):48-57. https://doi.org/10.1111/bcp.12....
3.
Schwartz PJ, Spazzolini C, Crotti L. The Jervell and Lange-Nielsen Sundrome: natural history, molecular basis and clinical outcome. Circulation. 2006;113:783-90. https://doi.org/10.1161/CIRCUL....
4.
Combined List of Drugs that Prolong QT and/or cause Torsades de Pointes (TdP). Retrieved on 16 Feb. 2016 from https://crediblemeds.org/healt....
5.
Woosley R. Drugs that prolong the QTc interval and/or induce torsade de pointes. Retrieved on 3 Mar. 2015 from http://www.crediblemeds.org/ev....
6.
Iannini PB, Circiumaru I, Byazrova E, Doddamani S, Kramer H. QTc prolongation associated with levofloxacin [abstr]. In: Program and abstracts of the 40th Interscience Conference on Antimicrobial Agents and Chemotherapy, Toronto, Ontario, Canada. Washington: American Society for Microbiology. 2000.
7.
Meyer FP. QT-Intervall-Verlangerung durch Pharmaka. Rardiotoxizitat von Arzneimitteln. Mschr Kinderheilk. 2004;25:967-73.
8.
Owens RC. Risk Assessment for Antimicrobial Agent-Induced QTc Interval Prolongation and Torsades de Pointes. Pharmacotherapy. 2001;21:310-19. https://doi.org/10.1592/phco.2....
9.
Malik M, Camm AJ. Evaluation of drug-induced QT interval prolongation:implications for drug approval and labelling. Drug Saf. 2001;24:323–51. https://doi.org/10.2165/000020....
10.
Arsentyeva RKh. Long QT syndrome. The Bulletin of Contemporary Clinical Medicine. 2012;5(3):129-138. https://doi.org/10.20969/VSKM.....
11.
Camn AJ, Lusher TF, Serruys PW. The ESC Textbook of Cardiovascular Medicine. Moscow: Geotarmedia. 2011.
12.
Sychev DA. Polipragmazija v klinicheskoj praktike: problema i reshenija. St.Patersburg: COP «Professija». 2016.
13.
Sychev DA, Bordovsky SP, Danilina KS, Ilyina, ES. Inappropriate prescribing in older people: STOPP/START criteria. Clin. Pharmacol. Ther. 2016;25(1):76-81.
14.
Sychev DA, Otdelenov VA. Mezhlekarstvennye vzaimodejstvija v praktike internista: vzgljad klinicheskogo farmakologa. Spravochnik poliklinicheskogo vracha. 2014;12:18-21.
15.
Sychev DA, Sosnovsky EE, Orekhov RE, Bordovsky SP. Contemporary methods of dealing with polypharmacy in elderly and senile patients. Siberian Medical Review. 2016;2(98):352-367. https://doi.org/10.20333/25000....
16.
Dresser GK, Spence JD, Bailey DG. Pharmacokinetic-pharmacodynamic consequences and clinical relevance of cytochrome P450 3A4 inhibition. Clin Pharmacokinet. 2000;38(1):41-57. https://doi.org/10.2165/000030....
17.
Ismagilov AD, Shich EV, Sizova ZhM, Dorofeeva MN, Tyajelnikov AA. Clinical and pharmacological aspects of drugs administration that influence on qt interval in elderly patients. Clinical Gerontology. 2016;4(22):37-45.
18.
Taizhanova DZ, Romaniuk YL. Syndrome of the QT interval prolongation: diagnosis and treatment. International Journal of Applied And Fundamental Research. 2015;3:218-21.
19.
Furman NV, Shmatova SS. Problems and prospects of intermediary metabolism correction in patients with vascular comorbidity. Rational Pharmacotherapy in Cardiology. 2013;9(3):311-315. https://doi.org/10.20996/1819-....
20.
Shikh EV, Ismagilov AD, Dorofeeva MN, Sizova ZhM. Modern aspects of the safe use of extension QT interval medicines. Anesthesiology and Intensive Care. 2016;61(5):386-90. https://doi.org/10.18821/0201-....
21.
Shikh EV, Fomin ЕV, Shumyantseva VV, Bulko TV. Combined therapy of elderly patients with regard to drugs metabolis. Clinical Gerontology. 2012;3-4:54-8.
22.
Kao LW, Furbee RB. Drug-induced q-T prolongation. Med. Clin. North. Am. 2005;89(6):1125–44. https://doi.org/10.1016/j.mcna....
23.
Kannankeril P, Roden DM, Darbar D. Drug-induced long QT syndrome. Pharmacol Rev. 2010;62(4):760–81. https://doi.org/10.1124/pr.110....
24.
Vatutin NT, Kalinkina NV, Shevelyok AN. The Role of T-Wave Alternans in Prognosis of Risk of Sudden Cardiac Death. Kardiologiia. 2009;11:46.
25.
Fomin EV, Baychorov IH, Shih EV, Sizova ZhM. Preclinical Investigation of Pharmaceuticals Impact against Cytochrome P450 Activity and Prognosis of Substrate Affinity as Means for Providing Substrate Therapy Safety. Antibiotics and Chemotherapy. 2013;7:34-9.
Share
RELATED ARTICLE
| eISSN: | 2516-3507 |
We process personal data collected when visiting the website. The function of obtaining information about users and their behavior is carried out by voluntarily entered information in forms and saving cookies in end devices. Data, including cookies, are used to provide services, improve the user experience and to analyze the traffic in accordance with the Privacy policy. Data are also collected and processed by Google Analytics tool (more).
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
