Klin Farmakol Farm. 2003;17(3):158-165

Proarytmie - závažné nežiadúce účinky liekov

Gabriela Kaliská
Stredoslovenský ústav srdcovo-cievnych chorôb, Banská Bystrica

Proarytmie typu torsades de pointes (TdP) sú potencionálne letálnym nežiadúcim účinkom kardiovaskulárnych nekardiovaskulárnych liekov. Mechanizmus ich vzniku je blokáda iónových kanálov IKr, sprievodným znakom je predĺženie repolarizácie, disperzia repolarizácie a predĺženie intervalov Q-T na elektrokardiograme. V článku sa rozoberajú základné elektrofyziologické mechanizmy TdP, riziká ich vzniku, vzťahy ku farmakokinetike liekov. Uvádzajú sa najčastejšie predpisované liekové skupiny s vysokým proarytmickým potenciálom. Rozoberajú sa možnosti prevencie.

Keywords: proarrhytmias, torsades de pointes, drugs.

Published: December 31, 2003  Show citation

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Kaliská G. Proarytmie - závažné nežiadúce účinky liekov. Klin Farmakol Farm. 2003;17(3):158-165.

Proarytmie typu torsades de pointes (TdP) sú potencionálne letálnym nežiadúcim účinkom kardiovaskulárnych a nekardiovaskulárnych liekov. Mechanizmus ich vzniku je blokáda iónových kanálov IKr, sprievodným znakom je predĺženie repolarizácie, disperzia repolarizácie a predĺženie intervalov Q-T na elektrokardiograme.

V článku sa rozoberajú základné elektrofyziologické mechanizmy TdP, riziká ich vzniku, vzťahy ku farmakokinetike liekov. Uvádzajú sa najčastejšie predpisované liekové skupiny s vysokým proarytmickým potenciálom. Rozoberajú sa možnosti prevencie.

Kľúčové slová

proarytmie, torsades de pointes, lieky.

Proarrhytmias - severe adverse drugs effects

Arrhymias of torsades de pointes type are possibly letal side effect of both cardiovascular and noncardiovascular drugs. Mechanism of their origin involves the blockage of ion channel Ikr, the accompanying feature of which are extension and dispersion ofrepolarization phase, prolongation of QT interval on ECG.

Basic electrophysiologic mechanisms of TdP, risks of their development and relations to drug pharmacokinetics are all discussed in this article. The most commonly prescribed drug groups with high proarrythmogenic effect are given. Possibilities of prevention are mentioned.

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