QT interval prolongation in hospitalized patients on cardiology wards: a prospective observational study

Khan, Qudrat; Ismail, Mohammad; Haider, Iqbal; Haq, Inam; Noor, Sidra

doi:10.1007/s00228-017-2321-4

Cited by 14 publications

(16 citation statements)

References 26 publications

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“…La frecuencia de SQTP (21%) fue mayor al reportado en otros estudios. En una investigación realizada de hospitales universitarios de Pakistán, la frecuencia de SQTP fue 17,3% y los factores de riesgo asociados fueron el sexo masculino, la edad añosa, la polifarmacia y el uso de fármacos listados (7,12,26)…”

Section: Discussionunclassified

Prolonged QTc interval in patients of Clinical Medicine: multicenter study

Roy¹,

Giménez²,

Cardozo³

et al. 2020

Rev. virtual Soc. Parag. Med. Int

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Antecedentes: el síndrome de QT prolongado (SQTP) adquirido se asocia al uso de ciertos fármacos. La detección oportuna del SQTP permite tomar medidas para prevenir arritmias ventriculares potencialmente letales. Objetivo: determinar la frecuencia de SQTP en pacientes adultos internados en Servicios de Clínica Médica, describir las características demográficas, clínicas, laboratoriales y el uso de fármacos asociados con la prolongación del intervalo QTc. Materiales y métodos: se aplicó diseño observacional, prospectivo, longitudinal, en varones y mujeres, mayores de 16 años de edad, internados en el Servicio de Clínica Médica del Hospital Nacional (Itauguá, Paraguay) y del Hospital Militar Central (Asunción, Paraguay) en 2019. Se midieron variables demográficas, clínicas, laboratoriales y un electrocardiograma (ECG) al ingreso y a la semana de internación. Se consideró STQL todo valor del intervalo QTc ≥0,45 seg en hombres y ≥0,47 seg en mujeres. Resultados: ingresaron al estudio 257 sujetos, 55% varones y 45% mujeres, con edad media 58±20 años. Se detectó SQTP en 55 pacientes (21%). Los fármacos más utilizados en los pacientes con SQTP fueron omeprazol, furosemida, piracilina-tazobactam, tramadol, ondasentrón, amiodarona, salbutamol, ciprofloxacina, antirretrovirales, levofloxacina, metoclopramida y cotrimoxazol. Conclusión: la frecuencia de SQTP fue 21%. La comorbilidad más frecuente fue la hipertensión arterial (62%). Los fármacos más utilizados en los pacientes con SQTP fueron los de uso común en las salas de Clínica Médica.

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Section: Discussionunclassified

Prolonged QTc interval in patients of Clinical Medicine: multicenter study

Roy¹,

Giménez²,

Cardozo³

et al. 2020

Rev. virtual Soc. Parag. Med. Int

View full text Add to dashboard Cite

show abstract

“…However, such studies have been poorly addressed in developing countries like Pakistan. There are a few studies which have their own scope and limitations such as involving only QT prolonging DDIs [30], small sample size and different drug interactions screening tool [31], and primarily focused on medication safety [32]. Further, we cannot generalize the findings of developed countries to the developing countries because of variations in drug prescribing pattern, utilization of anticancer drugs, pattern of cancers, drug interactions screening before prescribing, and non-availability of standard healthcare services.…”

Section: Introductionmentioning

confidence: 99%

Prevalence and significance of potential drug-drug interactions among cancer patients receiving chemotherapy

Ismail

Khan

et al. 2020

BMC Cancer

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Background: Cancer patients often receive multiple drugs to maximize their therapeutic benefit, treat co-morbidities and counter the adverse effects of chemotherapy. Concomitant administration of multiple drugs increases the risk of drug interactions leading to compromised therapeutic efficacy or safety of therapy. The purpose of this study was to identify the prevalence, levels and predictors of potential drug-drug interactions (pDDIs) among cancer patients. Methods: Six hundred and 78 patients receiving chemotherapy from two tertiary care hospitals were included in this cross-sectional study. Patient medication profiles were screened for pDDIs using the Micromedex® database. Logistic regression analysis was performed to identify the predictors of pDDIs. Results: The overall prevalence of pDDIs was 78%, majority of patients had 1-2 pDDIs (39.2%). A total of 1843 pDDIs were detected. Major-pDDIs were most frequent (67.3%) whereas, a significant association of pDDIs was found between > 7 all prescribed drugs (p < 0.001) and ≥ 3 anti-cancer drugs (p < 0.001). Potential adverse outcomes of these interactions include reduced therapeutic effectiveness, QT interval prolongation, tendon rupture, bone marrow suppression and neurotoxicity. Conclusions: Major finding of this study is the high prevalence of pDDIs signifying the need of strict patient monitoring for pDDIs among cancer patients. Patients at higher risk to pDDIs include those prescribed with > 7 any types of drugs or ≥ 3 anticancer drugs. Moreover, list of most frequently identified major and moderate interactions will aid health care professional in timely identification and prevention of pDDIs.

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“…Assessing patients' abnormal signs/symptoms and laboratory investigations help in monitoring the adverse consequences associated with DDIs. The potential negative consequences of ten most frequent pDDIs, observed in this study and published reports, emphasis the need of monitoring patients using these combinations [9,37,38]. In this study, doses of the interacting drugs have also been considered.…”

Section: Discussionmentioning

confidence: 93%

Drug-drug interactions associated with adverse clinical outcomes and abnormal laboratory findings in patients with malaria

Noor

Ismail

Khadim

2020

Preprint

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Background: Hospitalized patients with malaria often present with comorbidities or associated complications for which a variety of drugs are prescribed. Multiple drug therapy often leads to drug-drug interactions (DDIs). Therefore, we investigated the prevalence, levels, risk factors, clinical relevance, and monitoring parameters/management guidelines of potential DDIs (pDDIs) among inpatients with malaria. Methods: A retrospective cohort study was carried out at multiple hospital settings. A total of 398 patients’ profiles were evaluated for pDDIs using the Micromedex Drug-Reax ® . Odds ratios were calculated to identify the strength of association between presence of DDIs and potential risk factors via logistic regression analysis. Further, the clinical relevance of frequent pDDIs was investigated. Results: Of 398 patients, pDDIs were observed in 37.2% patients, while major-pDDIs in 19.3% patients. Total 325 interaction were found, of which 45.5% were of major- and 34.5% moderate-severity. Patients with the most common pDDIs were found with signs/symptoms and abnormalities in laboratory findings representing nephrotoxicity, hepatotoxicity, QT interval prolongation, and reduced therapeutic efficacy . The adverse events were more common in patients prescribed with the higher doses of interacting drugs. Multivariate regression analysis showed statistically significant association of pDDIs with 5-6 prescribed medicines (p=0.01), >6 prescribed medicines (p<0.001), >5 days of hospital stay (p=0.03), and diabetes mellitus (p=0.04). Conclusions: PDDIs are commonly observed in patients with malaria. Healthcare professional’s knowledge about the most common pDDIs could help in preventing pDDIs and their associated negative effects. Pertinent clinical parameters, such as laboratory findings and signs/symptoms need to be checked, particularly in patients with polypharmacy, longer hospital stay, and diabetes mellitus.

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QT interval prolongation in hospitalized patients on cardiology wards: a prospective observational study

Cited by 14 publications

References 26 publications

Prolonged QTc interval in patients of Clinical Medicine: multicenter study

Prolonged QTc interval in patients of Clinical Medicine: multicenter study

Prevalence and significance of potential drug-drug interactions among cancer patients receiving chemotherapy

Drug-drug interactions associated with adverse clinical outcomes and abnormal laboratory findings in patients with malaria

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