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多奈哌齐与QTc间期延长及尖端扭转型室速之间的相关性:一种极为罕见的现象。

Correlation Between Donepezil and QTc Prolongation and Torsades de Pointes: A Very Rare Phenomenon.

作者信息

Malik Bilal Haider, Hamid Pousette, Khan Safeera, Gupta Deepti, Islam Muhammad

机构信息

Internal Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA.

Neurology, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA.

出版信息

Cureus. 2019 Dec 23;11(12):e6451. doi: 10.7759/cureus.6451.

Abstract

Dementia can be seen as a clinical syndrome featuring a decline in cognitive and psychological abilities that can cause disability. Two major kinds of drugs are available: N-methyl-D-aspartic acid receptor antagonists like memantine and acetylcholinesterase inhibitors such as galantamine, rivastigmine and donepezil. In this article, we have reviewed the available literature along with the provision of a snapshot of published cases in the literature We used the PubMed database for our search. The average age of patients was 80 years and above. Patients described in the literature belonged to both female and male gender, with female patients being predominant. Patients demonstrated associated atrioventricular (AV) block or ventricular premature contractions (VPC) or atrial fibrillation (AF) prior to developing torsades de pointes (TdP). Presenting complaints were either syncope or diarrhoea or accidental bradycardia. Mostly, the corrected QT interval (QTc) normalisation was associated with discontinuation of donepezil. We recommend further studies to determine this correlation between donepezil and incidence of QTc prolongation and TdP.

摘要

痴呆可被视为一种以认知和心理能力下降为特征的临床综合征,这种下降可能导致残疾。有两大类药物可供使用:N-甲基-D-天冬氨酸受体拮抗剂,如美金刚;以及乙酰胆碱酯酶抑制剂,如加兰他敏、卡巴拉汀和多奈哌齐。在本文中,我们回顾了现有文献,并提供了文献中已发表病例的简要情况。我们使用PubMed数据库进行检索。患者的平均年龄在80岁及以上。文献中描述的患者有男性也有女性,以女性患者居多。患者在发生尖端扭转型室性心动过速(TdP)之前表现出相关的房室(AV)阻滞、室性早搏(VPC)或心房颤动(AF)。出现的症状为晕厥、腹泻或意外心动过缓。大多数情况下,QTc间期正常化与停用多奈哌齐有关。我们建议进一步开展研究,以确定多奈哌齐与QTc延长发生率和TdP之间的这种相关性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/792a/6977576/8826ed93e811/cureus-0011-00000006451-i01.jpg

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