[Risk management of QT-prolonging drugs by community pharmacists using a mobile electrocardiograph].
Yakugaku Zasshi
; 130(11): 1597-601, 2010 Nov.
Article
em Ja
| MEDLINE
| ID: mdl-21048421
ABSTRACT
Prolongation of the QT interval is associated with a high risk of serious arrhythmia, i.e., torsades de pointes (TdP). However, in many cases, the QT-prolonging drug(s) is prescribed without performing a thorough check-up of the patient's condition, especially an electrocardiogram. In addition to patient interview, we used an electrocardiogram obtained with a mobile electrocardiograph (RMH-ECG) in a community pharmacy in order to improve the risk management for QT-prolonging drugs. A comparison of the results obtained using RMH-ECG (modified I) and 12-lead ECG (I) revealed that both corrected QT (QTc) values were almost identical, and the correlation coefficient was 0.96. In one month, 5 of 948 patients who visited our pharmacy and continuously took QT-prolonging drugs had additional risk factors for TdP (advanced age, female, and drug-drug interaction). We monitored the QT interval of one of these patients. She had received erythromycin for 19 months along with other drugs metabolized by a P450 (CYP3A4); benidipine and prednisolone (for over 2 years), and tacrolimus (for 13 weeks). Three RMH-ECG tests at every 2 weeks revealed that QTcs were normal (0.43-0.45 s); therefore, we dispensed drugs without any change in the prescription. Approximately 1 in 1200 individuals has a prolonged QT interval without any subjective symptoms, and the time window of drug-induced TdP is considered to be from several hours to months after taking these drugs. Therefore, we think that an ECG test should be performed in community pharmacies before dispensing QT-prolonging drugs and that the QT interval should be monitored.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Gestão de Riscos
/
Síndrome do QT Longo
/
Torsades de Pointes
/
Serviços Comunitários de Farmácia
/
Eletrocardiografia
/
Antiarrítmicos
Tipo de estudo:
Etiology_studies
/
Risk_factors_studies
Limite:
Aged
/
Female
/
Humans
Idioma:
Ja
Revista:
Yakugaku Zasshi
Ano de publicação:
2010
Tipo de documento:
Article
País de afiliação:
Japão