Dextropropoxyphene effects on QTc-interval prolongation: Frequency and characteristics in relation to plasma levels
| Autor: | Guillermo Di Girolamo, Roberto Alejandro Diez, Patricia N. Quiroga, Guillermo Alberto Keller, Nicolás Fernández, Nancy Mónica Olivera, Cecilia Villa Etchegoyen |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty Argentina Propoxyphene Action Potentials QT interval Electrocardiography chemistry.chemical_compound Heart Conduction System Heart Rate Risk Factors Internal medicine medicine Humans Pharmacology (medical) Longitudinal Studies Prospective Studies cardiovascular diseases Prospective cohort study Aged Aged 80 and over Dextropropoxyphene Framingham Risk Score medicine.diagnostic_test business.industry Norpropoxyphene Prolongation Arrhythmias Cardiac General Medicine Middle Aged Analgesics Opioid Anesthesiology and Pain Medicine chemistry Qtc interval prolongation Cardiology Female Drug Monitoring business medicine.drug |
| Zdroj: | Journal of Opioid Management. 14:335-344 |
| ISSN: | 1551-7489 |
| DOI: | 10.5055/jom.2018.0466 |
| Popis: | Objective: To evaluate frequency and risk factors for dextropropoxyphene-induced QT-interval prolongation in the clinical setting. Design: Prospective, noninterventional, observational, longitudinal cohort approach. Electrocardiograms were blindly evaluated by independent professionals. Setting: General ward of a public hospital of metropolitan Buenos Aires. Patients, Participants: Ninety-two patients with indication of receiving dextropropoxyphene for analgesic purposes were included consecutively. All patients finished the study. Interventions: All patients were monitored with electrocardiographic controls (previous to drug administration and during steady state) to diagnose and quantify changes in the duration of the QTc interval. Main Outcome Measure: Frequency of drug-induced QTc interval prolongation, QTc interval correlation with plasma drug, and metabolite levels. Results: Ninety-two patients were studied (50 percent males). All patients received a (mean ± SD [range]) dextropropoxyphene dose of 125 ± 25[100-150] mg/d. Dextropropoxyphene and norpropoxyphene concentrations were 112 ± 38[45-199] and 65 ± 33[13-129] ng/mL, respectively. The intra-treatment QTc interval was >450 ms in only one patient (only with the Hodge correction). There were no cases of QTc > 500 ms, and there were no significant differences in the results considering different correction formulas (Bazzet, Fridericia, Framingham, Hodges). Dextropropoxyphene concentrations correlated with QTc (R > 0.45) interval and ΔQTc (R 0.52-0.87), whereas norpropoxyphene correlation was even greater for QTc (R > 0.40-0.64) and ΔQTc (R > 0.47-0.92). Depending on the QTc correction formula, eight patients presented ΔQTc > 30 ms and one patient with ΔQTc > 60 ms. No patient presented arrhythmia during the study. Conclusions: The authors did not observe a relationship between dextropropoxyphene and QTc interval prolongation at the therapeutic doses used in Argentina. |
| Databáze: | OpenAIRE |
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