Efeitos da Heroína nos Parâmetros Eletrocardiográficos

Yıldırım, Ersin; Selçuk, Murat; Şaylık, Faysal; Mutluer, Ferit Onur; Deniz, Ozgur

doi:10.36660/abc.20190296

Cited by 5 publications

(3 citation statements)

References 29 publications

(69 reference statements)

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“…QT interval prolongation was reported in previous studies of addiction population; however, it was usually related to cocaine abuse or concurrent methadone therapy (Demarie et al, 2011). (Yildirim et al, 2020) demonstrated that heroin abuse significantly changed QT interval independent from the effect of adulterants and methadone. Tramadol also is known as an intermediate risk drug for developing long QT interval in high doses (Behzadi et al, 2018).…”

Section: Discussionmentioning

confidence: 98%

Prevalence and Evaluation of Cardiac Complications Among Patients With Substance Abuse in Al Hussein University Hospital

2022

Al-Azhar Medical Journal

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Background: Substance abuse refers to excessive use of a drug in a way that is detrimental to self, society, or both. Substance abuse and its health outcomes has become a major public health issue in Egypt in recent years.Objective: To determine the prevalence of electrocardiographic and echocardiographic abnormalities among substance abusers who have low cardiovascular risk profile and evaluate the relation between these abnormalities and substance abuse.

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Section: Discussionmentioning

confidence: 98%

Prevalence and Evaluation of Cardiac Complications Among Patients With Substance Abuse in Al Hussein University Hospital

2022

Al-Azhar Medical Journal

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“…Diacetylmorphine has varying degrees of effect on various tissues and organs in the body, with the most serious side effects being respiratory depression and gastrointestinal depression 8 – 10 . It has also been demonstrated that diacetylmorphine can cause abnormal electrocardiographic parameters 11 ; however, little is known about the mechanisms by which diacetylmorphine causes myocardial rhythm abnormalities.…”

Section: Introductionmentioning

confidence: 99%

CaMKII regulates the proteins TPM1 and MYOM2 and promotes diacetylmorphine-induced abnormal cardiac rhythms

Liu

et al. 2023

Sci Rep

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Although opioids are necessary for the treatment of acute pain, cancer pain, and palliative care, opioid abuse is a serious threat to society. Heroin (Diacetylmorphine) is the most commonly abused opioid, and it can have a variety of effects on the body's tissues and organs, including the well-known gastrointestinal depression and respiratory depression; however, there is little known about the effects of diacetylmorphine on cardiac damage. Here, we demonstrate that diacetylmorphine induces abnormal electrocardiographic changes in rats and causes damage to cardiomyocytes in vitro by an underlying mechanism of increased autophosphorylation of CaMKII and concomitant regulation of myocardial contractile protein TPM1 and MYOM2 protein expression. The CaMKII inhibitor KN-93 was first tested to rescue the toxic effects of heroin on cardiomyocytes in vitro and the abnormal ECG changes caused by heroin in SD rats, followed by the TMT relative quantitative protein technique to analyze the proteome changes. Diacetylmorphine causes increased phosphorylation at the CaMKII Thr287 site in myocardium, resulting in increased autophosphorylation of CaMKII and subsequent alterations in myocardial contractile proteins, leading to myocardial rhythm abnormalities. These findings provide a theoretical basis for the treatment and prevention of patients with arrhythmias caused by diacetylmorphine inhalation and injection.

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“…Entre seus efeitos adversos, o principal é a dificuldade respiratória, que pode ser fatal. A literatura ainda descreve outras complicações, como choque, lesão miocárdica, edema pulmonar, lesão renal aguda, rabdomiólise e leucoencefalopatia(YILDIRIM et al, 2020). Para evitar tais eventos a longo prazo, opta-se por utilizar…”

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Os desafios da Anestesiologia frente ao manejo dos pacientes usuários de drogas ilícitas

Simões de Castro,

Lima,

Rocha

et al. 2024

Braz. J. Implantol. Health Sci.

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Introdução: O uso de drogas ilícitas, cada vez mais presente na atualidade, influencia diretamente na administração de anestésicos, sejam eles locais ou gerais, em cirurgias eletivas ou em caráter de urgência. A análise pré-operatória das condições clínicas do paciente é essencial para que seja traçada uma boa conduta anestésica, uma vez que usuários crônicos de drogas como maconha, cocaína, crack, ecstasy e heroína estão mais susceptíveis a efeitos adversos do anestésico, levando a um prognóstico operatório e pós-operatório ruim. Sendo assim, o objetivo do presente trabalho é o de analisar a literatura acerca do tema. Metodologia: Foi usada uma metodologia qualitativa, sem procura por dados quantitativos. Resultados e Discussão: Quanto aos resultados, aqueles que são usuários de maconha apresentaram maior resistência a anestésicos inalatórios e gerais, necessitando maiores posologias; no que diz respeito ao uso de cocaína e crack, anestesias locais podem ocasionar reações de toxicidade, devido ao efeito aditivo que essas drogas trazem à interação medicamentosa; aqueles que são usuários de ecstasy também apresentam risco de efeitos adversos, como lesão hepática, aumento da pressão arterial, hipertermia, convulsões e acidentes vasculares encefálicos (AVEs), sendo necessária a aplicação de um bloqueador neuromuscular junto à anestesia; quanto à heroína, por ela ser um opióide, anestésicos antagonistas dessa classe são a melhor opção, para evitar reações prejudiciais ao paciente. Conclusão: Logo, cabe à equipe cirúrgica, em casos eletivos, analisar a história do paciente para determinar boas condutas operatórias e, em situações de urgência, é responsabilidade do anestesista o cálculo das possíveis dosagens e interações dos anestésicos com o sistema do paciente, ainda que seja de difícil precisão.

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Efeitos da Heroína nos Parâmetros Eletrocardiográficos

Cited by 5 publications

References 29 publications

Prevalence and Evaluation of Cardiac Complications Among Patients With Substance Abuse in Al Hussein University Hospital

Prevalence and Evaluation of Cardiac Complications Among Patients With Substance Abuse in Al Hussein University Hospital

CaMKII regulates the proteins TPM1 and MYOM2 and promotes diacetylmorphine-induced abnormal cardiac rhythms

Os desafios da Anestesiologia frente ao manejo dos pacientes usuários de drogas ilícitas

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