Department of Pharmaceutical and Pharmacological Sciences, Clinical Pharmacology and Pharmacotherapy, KU Leuven - University of Leuven, Herestraat 49, Box 521, 3000, Leuven, Belgium,
Int J Clin Pharm. 2014 Aug;36(4):757-65. doi: 10.1007/s11096-014-9953-6. Epub 2014 May 8.
Drug-induced QT-prolongation is an established risk factor for Torsade de pointes and sudden cardiac death. The list of QT-prolonging drugs is extensive and includes many drugs commonly used in psychiatry.
In this study we performed a cross-sectional analysis of medication profiles to assess the prevalence of drug interactions potentially leading to QT-prolongation.
6 psychiatric hospitals in Flanders, Belgium.
For each patient, the full medication list was screened for the presence of interactions, with special attention to those with an increased risk for QT-prolongation. Current practice on QT monitoring and prevention of drug-induced arrhythmia was assessed.
Number of drug interactions with risk of QT-prolongation.
592 patients (46 % female; mean age 55.7 ± 17.1 years) were included in the analysis. 113 QT-prolonging interactions were identified in 43 patients (7.3 %). QT-prolonging interactions occurred most frequently with antidepressants (n = 102) and antipsychotics (n = 100). The precautions and follow-up provided by the different institutions when combining QT-prolonging drugs were very diverse.
Drug combinations that are associated with QT-prolongation are frequently used in the chronic psychiatric setting. Persistent efforts should be undertaken to provide caregivers with clear guidelines on how to use these drugs in a responsible and safe way.
药物引起的 QT 延长是尖端扭转型室性心动过速和心脏性猝死的既定危险因素。QT 延长药物的清单很长，其中包括许多常用于精神病学的药物。
在这项研究中，我们对药物概况进行了横断面分析，以评估潜在导致 QT 延长的药物相互作用的发生率。
比利时佛兰德斯的 6 家精神病院。
对每位患者的完整药物清单进行筛查，以确定是否存在相互作用，特别注意那些有增加 QT 延长风险的药物。评估了目前 QT 监测和预防药物引起的心律失常的情况。
具有 QT 延长风险的药物相互作用的数量。
共纳入 592 名患者（46%为女性；平均年龄 55.7 ± 17.1 岁）进行分析。在 43 名患者（7.3%）中发现了 113 种 QT 延长相互作用。与抗抑郁药（n = 102）和抗精神病药（n = 100）最常发生 QT 延长相互作用。不同机构在联合使用 QT 延长药物时提供的预防措施和随访非常多样化。
与 QT 延长相关的药物联合在慢性精神病环境中经常使用。应持续努力为护理人员提供如何以负责任和安全的方式使用这些药物的明确指南。
