QT延长抗菌药物:理解意义。

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QT延长抗菌药物:理解意义。

药。2004;64 (10):1091 - 124。

PubMed ID

15139788 (在PubMed

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文摘

心脏毒性相对少见在抗菌类药物,但好描述抗心律失常的药物和某些抗组胺药。大环内酯类、戊烷脒和某些抗疟药物通常都导致QT-interval延长,现在唑抗真菌,酮内酯抗生素氟喹诺酮类原料药和可以添加到列表中。随着时间的推移,QT-interval延长临床前测试方法的进步,更好的理解其后遗症,尤其是带条de同构(TdP)发生。结合这一事实,这五个药物了市场在过去的几年中,部分是因为QT-interval prolongation-related毒性,从而提升周围的紧迫性早期检测和描述方法对于评估non-antiarrhythmic药品类。技术进步和积累文献关于QT延长,目前困难或压倒性的执业医生解释这些数据为目的的规定审查或个别病人的治疗决定。某些病人容易QT-prolonging药物的影响。例如,co-variates诸如性别、年龄、电解质紊乱、结构性心脏病、器官损伤和结束,也许最重要的是,遗传素质,是大多数(如果不是全部的话)的计划书的基础。之间和内部类的药物有重要的差异导致延迟repolarisation(例如内在力量抑制某些心脏离子电流或渠道,和药物动力学)。为此,危险分层方案可能有用的排名和比较每种药物的潜在毒性。看来,在大多数情况下发表的antimicrobial-associated计划书,多个风险因素存在。 Macrolides in general are associated with a greater potential than other antimicrobials for causing TdP from both a pharmacodynamic and pharmacokinetic perspective. The azole antifungal agents also can be viewed as drugs that must be weighed carefully before use since they also have both pharmacodynamic and pharmacokinetic characteristics that may trigger TdP. The fluoroquinolones appear less likely to be associated with TdP from a pharmacokinetic perspective since they do not rely on cytochrome P450 (CYP) metabolism nor do they inhibit CYP enzyme isoforms, with the exception of grepafloxacin and ciprofloxacin. Nonetheless, patient selection must be carefully made for all of these drugs. For clinicians, certain responsibilities are assumed when prescribing antimicrobial therapy: (i) appropriate use to minimise resistance; and (ii) appropriate patient and drug selection to minimise adverse event potential. Incorporating information learned regarding QT interval-related adverse effects into the drug selection process may serve to minimise collateral iatrogenic toxicity.

DrugBank数据引用了这篇文章

药物酶

药物	酶	类	生物	药理作用	行动
Grepafloxacin	细胞色素P450 3 a4	蛋白质	人类	未知的	底物	细节