Produljenje QT intervala kao posljedica uzimanja lijekova

master's thesis

• Title (english): Drug induced QT interval prolongation
• Author: Dora Bračko
• Mentor: Natalija Dedić Plavetić (mentor)
• Committee member: Stjepko Pleština (predsjednik povjerenstva)
• Committee member: Jasenka Markeljević (član povjerenstva)
• Committee member: Natalija Dedić Plavetić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Pathophysiology); Zagreb
• Defense date and country: 2019-07-12, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Pathophysiology
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Clinical Pharmacology and Toxicology

Abstract

QT interval je elektrokardiografska manifestacija ventrikulske depolarizacije i repolarizacije posredovana ionskim kanalima čija je duljina određena dobi, spolom i frekvencijom srca, a kao referentne vrijednosti uzimaju se duljine 360-390 ms kod muškaraca i 370-400 ms u žena. QT interval smatra se produljenim ako je dulji od 440 ms kod muškaraca ili 460 ms kod žena. Produljenje je uzrokovano različitim modificirajućim i nemodificirajućim čimbenicima, a kao najčešći zabilježeni su raznovrsni lijekovi koji imaju tendenciju produljenja QT intervala. Ti lijekovi imaju zabilježene različite vjerojatnosti nastanka abnormalnosti u EKG nalazu koje, osim o lijeku, ovise i o ostalim prisutnim čimbenicima i kliničkim stanjima. Produljeni QT interval povezan je s povećanim rizikom od nastanka polimorfnog oblika ventrikulske tahikardije torsade de pointes koja može dovesti do iznenadne smrti. Kod propisivanja lijekova, koji kao nuspojavu imaju produljenje QT intervala, potrebno je procijeniti odnos između koristi i štetnosti tog lijeka te identificirati ostale rizične čimbenike i stanja koji bi u interakciji s tim lijekovima doveli do aritmije. Takve je pacijente potrebno pažljivo monitorirati i pratiti, razmotriti moguću zamjenu lijeka za onaj lijek koji ne uzrokuje abnormalnosti u EKG nalazu te pravilno zbrinuti prema određenim smjernicama u slučaju razvoja produljenog QT intervala i torsade de pointes.

Abstract (english)

QT interval is electrocardiographic manifestation of ventricular depolarization and repolarization mediated through ion channels. Length of QT interval is determined by age, gender and heart rate. Reference values of QT interval are 360-390 ms in men and 370-400 ms in women. QT interval is considered extended if it is longer than 440 ms in men or 460 ms in women. QT prolongation is caused by different modifiable and unmodifiable risk factors and the most common are medications which have tendency to extend QT interval. Those medications have different probabilities of developing ECG abnormalities which depend also on present risk factors and clinical conditions. QT prolongation is associated with higher risk of developing polymorphic ventricular tachycardia torsade de pointes which can lead to sudden death. While prescribing medications, which can extend QT interval, it is neccessary to assess the relationship between benefits and risks and to identify other risk factors and conditions which could interact with those medications. Those patients should be carefully monitored. Alternative medicine should be considered. Proper care should be provided for patients who developed QT prolongation or torsade de pointes.

• Keywords: QT interval; produljenje; torsade de pointes
• Keywords (english): QT interval; prolongation; torsade de pointes
• Language: croatian
• URN:NBN: urn:nbn:hr:105:899879
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2020-02-19 11:54:28