1 University of California San Francisco Medical Center, San Francisco, CA, USA.
2 Scripps MD Anderson Cancer Center, San Diego, CA, USA.
Ann Pharmacother. 2019 Jul;53(7):705-710. doi: 10.1177/1060028019829494. Epub 2019 Feb 1.
Quetiapine is an atypical antipsychotic commonly utilized for the management of delirium in critically ill patients. The impact of quetiapine on QTc in the critically ill population is largely unknown.
The purpose of this study was to evaluate QTc prolongation following administration of quetiapine for the management of delirium in critically ill patients.
This was a single-center prospective, observational cohort study. QTc measurements of patients who received at least one dose of quetiapine were compared with a control group receiving melatonin. The primary outcome was mean change in QTc from baseline to maximum serum drug concentration after the first dose of quetiapine.
No significant change in QTc was observed from baseline to post-quetiapine administration, with a mean change in QTc of 2.7 ms (438.4 ± 43.2 ms vs 441.1 ± 36.4 ms; P = 0.50). When comparing mean change in QTc between the quetiapine group and melatonin group, the difference was not significant (2.7 ± 37.8 ms vs -0.18 ± 32.0 ms, P = 0.73). Conclusion and Relevance: This study represents one of the first prospective studies evaluating the impact of quetiapine on QTc. The results of this study demonstrate a nonsignificant statistical and clinical change in the QTc following quetiapine administration in critically ill patients utilizing telemetry measurements. Routine QTc monitoring with formal electrocardiogram(s) following quetiapine administration may not be warranted.
喹硫平是一种常用于治疗重症患者谵妄的非典型抗精神病药。喹硫平对危重症人群 QTc 的影响尚不清楚。
本研究旨在评估喹硫平治疗重症患者谵妄时 QTc 延长情况。
这是一项单中心前瞻性观察性队列研究。比较了接受至少一剂喹硫平的患者与接受褪黑素的对照组的 QTc 测量值。主要结局是喹硫平首剂后最大血清药物浓度时 QTc 从基线的平均变化。
从基线到喹硫平给药后，未观察到 QTc 有显著变化，平均 QTc 变化为 2.7ms（438.4±43.2ms 比 441.1±36.4ms；P=0.50）。比较喹硫平组和褪黑素组 QTc 平均变化，差异无统计学意义（2.7±37.8ms 比-0.18±32.0ms，P=0.73）。
本研究是评估喹硫平对 QTc 影响的首批前瞻性研究之一。本研究结果表明，在使用遥测测量的危重症患者中，喹硫平给药后 QTc 无统计学和临床意义的变化。喹硫平给药后可能不需要常规进行 QTc 监测和正式心电图检查。
