Taylor C T, Donaldson A R
Department of Pharmacy Practice, Auburn University School of Pharmacy, Alabama, USA.
Pharmacotherapy. 2001 Apr;21(4):488-92. doi: 10.1592/phco.21.5.488.34496.
To determine the safety and effectiveness of ibutilide, we conducted a retrospective study of patients in a community hospital from December 1997-January 2000, reviewing hospital and pharmacy records for 12 inpatients (aged 68+/-13 yrs) receiving ibutilide for atrial fibrillation or flutter. The cumulative conversion rate with ibutilide 0.012+/-0.004 mg/kg was 58%. Serious cardiovascular adverse events were documented in six patients; of those patients, five had baseline QTc intervals above 440 msec, two experienced ventricular fibrillation, and four experienced symptomatic bradycardia (range 49-60 beats/minute) requiring medical intervention. The effectiveness of ibutilide was similar to that found in previous studies. However, more complications were seen in this setting where ibutilide was used infrequently and without stringent patient selection criteria or standardized administration protocols. To ensure optimal patient care, institutions should consider implementing guidelines or education strategies to reduce the potential for serious adverse effects associated with improper screening, dosing, and monitoring of patients receiving ibutilide.
为确定伊布利特的安全性和有效性，我们对1997年12月至2000年1月间一家社区医院的患者进行了一项回顾性研究，查阅了12例因房颤或房扑接受伊布利特治疗的住院患者（年龄68±13岁）的医院和药房记录。伊布利特剂量为0.012±0.004mg/kg时的累积转复率为58%。6例患者记录到严重心血管不良事件；在这些患者中，5例基线QTc间期超过440毫秒，2例发生室颤，4例出现症状性心动过缓（范围为49 - 60次/分钟）需要医疗干预。伊布利特的有效性与先前研究结果相似。然而，在伊布利特使用不频繁且没有严格的患者选择标准或标准化给药方案的情况下，出现了更多并发症。为确保为患者提供最佳护理，医疗机构应考虑实施指南或教育策略，以降低与接受伊布利特治疗患者的筛查、给药和监测不当相关的严重不良反应的可能性。
