Hoehns J D, Stanford R H, Geraets D R, Skelly K S, Lee H C, Gaul B L
College of Pharmacy, University of Iowa, Iowa City, USA.
Pharmacotherapy. 2001 Jul;21(7):871-83. doi: 10.1592/phco.21.9.871.34565.
To present a case of chlorpromazine-associated torsades de pointes, review established cases of ventricular arrhythmias associated with chlorpromazine, and describe the proarrhythmic characteristics of this drug.
Articles identified through a search of MEDLINE and IDIS from January 1966-November 2000 and thorough review of the article bibliographies. Patient cases also were identified from a search of the Food and Drug Administration's Adverse Event Reporting System database (November 1997-March 2001). Cases involving intentional overdoses of chlorpromazine were excluded.
In addition to the case reported herein, 12 cases of documented, chlorpromazine-associated ventricular arrhythmias were identified; five had characteristic features of torsades de pointes. Chlorpromazine delayed repolarization and produced electrocardiographic abnormalities; although, whether chlorpromazine induced torsades de pointes through a mechanism of early afterdepolarizations is unclear. Similar to other instances of drug-induced torsades de pointes, concurrent factors such as electrolyte deficiencies may place the patient at increased risk for arrhythmia.
Chlorpromazine can delay repolarization and produce electrocardiographic abnormalities. These can result infrequently in ventricular arrhythmias and torsades de pointes, particularly in patients with confounding factors.
报告1例氯丙嗪相关性尖端扭转型室速病例，回顾已确诊的与氯丙嗪相关的室性心律失常病例，并描述该药物的促心律失常特征。
通过检索1966年1月至2000年11月的MEDLINE和IDIS数据库，并全面查阅文章参考文献确定相关文章。还通过检索美国食品药品监督管理局不良事件报告系统数据库（1997年11月至2001年3月）确定患者病例。排除涉及故意过量服用氯丙嗪的病例。
除本文报告的病例外，还确定了12例有记录的氯丙嗪相关性室性心律失常病例；其中5例具有尖端扭转型室速的特征性表现。氯丙嗪可延迟复极化并产生心电图异常；不过，氯丙嗪是否通过早期后除极机制诱发尖端扭转型室速尚不清楚。与其他药物诱发的尖端扭转型室速情况类似，电解质缺乏等并发因素可能使患者发生心律失常的风险增加。
氯丙嗪可延迟复极化并产生心电图异常。这些情况偶尔可导致室性心律失常和尖端扭转型室速，尤其是在有混杂因素的患者中。
