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胺碘酮与氟哌啶醇联用对Q-Tc间期延长的影响。

Effects of concomitant amiodarone and haloperidol on Q-Tc interval prolongation.

作者信息

Bush Sarah E, Hatton Randy C, Winterstein Almut G, Thomson Margaret R, Woo Gregory W

机构信息

Pharmacy Services, Greenville Hospital System, Greenville, SC 29605, USA.

出版信息

Am J Health Syst Pharm. 2008 Dec 1;65(23):2232-6. doi: 10.2146/ajhp080039.

Abstract

PURPOSE

The effects of concomitant amiodarone and haloperidol on Q-Tc interval prolongation were studied.

METHODS

All adult patients admitted to a 618-bed tertiary referral teaching hospital between January 1, 2005, and December 31, 2006, who received amiodarone and haloperidol concomitantly were included in this retrospective descriptive analysis. Data collected to assess patients' risk of developing Q-T interval prolongation included age, sex, past medical history, and number of days of concomitant exposure. Data relevant for the assessment of cardiac effects were collected for the time period between 24 hours before and after the administration of haloperidol and included laboratory test values, use of other Q-T interval-prolonging drugs, heart rate, Q-Tc intervals, and clinical documentation of arrhythmia. To determine change in the Q-Tc interval, Q-T and R-R values were recorded using cardiac rhythm strips or electrocardiogram. Nurses' and physicians' records were reviewed to determine if an arrhythmia occurred. Descriptive statistics were used to analyze baseline patient information and Q-Tc interval data.

RESULTS

A total of 49 patients met inclusion criteria, yielding 381 distinct amiodarone-haloperidol exposures. During 138 (36.2%) of 381 haloperidol-amiodarone exposures, patients received at least one additional Q-T interval-prolonging drug. When amiodarone-haloperidol exposures were grouped by the number of concomitant Q-T prolonging drugs, no apparent association was detected between longer Q-Tc intervals and an increased number of concomitant Q-T interval-prolonging drugs.

CONCLUSION

A small, potentially significant Q-Tc interval prolongation, but not ventricular arrhythmia, was observed in adult patients who received a concomitant administration of amiodarone and haloperidol at a tertiary referral teaching hospital.

摘要

目的

研究胺碘酮与氟哌啶醇联用对Q-Tc间期延长的影响。

方法

纳入2005年1月1日至2006年12月31日期间入住一家拥有618张床位的三级转诊教学医院且同时接受胺碘酮和氟哌啶醇治疗的所有成年患者,进行这项回顾性描述性分析。为评估患者发生Q-T间期延长风险而收集的数据包括年龄、性别、既往病史以及同时用药天数。在氟哌啶醇给药前后24小时内收集与心脏效应评估相关的数据,包括实验室检查值、其他Q-T间期延长药物的使用情况、心率、Q-Tc间期以及心律失常的临床记录。为确定Q-Tc间期的变化,使用心律记录条或心电图记录Q-T和R-R值。查阅护士和医生的记录以确定是否发生心律失常。采用描述性统计分析患者基线信息和Q-Tc间期数据。

结果

共有49例患者符合纳入标准,产生381次胺碘酮与氟哌啶醇的不同用药暴露。在381次氟哌啶醇与胺碘酮用药暴露中,有138次(36.2%)患者至少额外使用了一种Q-T间期延长药物。当根据同时使用的Q-T延长药物数量对胺碘酮与氟哌啶醇用药暴露进行分组时,未发现Q-Tc间期延长与同时使用的Q-T间期延长药物数量增加之间存在明显关联。

结论

在一家三级转诊教学医院中,接受胺碘酮与氟哌啶醇联用的成年患者出现了轻度、可能具有显著意义的Q-Tc间期延长,但未出现室性心律失常。

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