QTc interval prolongation by d-propoxyphene: what about other analgesics?
Summary of "QTc interval prolongation by d-propoxyphene: what about other analgesics?"
Introduction: d-Propoxyphene, which was previously available in many single-agent and combination products, was recently voluntarily withdrawn from the US market following an FDA recommendation based partly on the concern that the risk associated with QT prolongation exceeded the clinical benefit of the drug. The drug had previously been withdrawn from European markets. These recent actions prompt the question: what is known about QT prolongation and analgesic drugs? Areas covered: A systematic search was conducted of 50 opioid and non-opioid analgesic drugs using PubMed, the FDA website, and the Internet. Search terms for opioids, NSAIDs, acetaminophen and other analgesics were used (including both generic and brand names), along with QTc, QTc prolongation, QTc interval, hERG, torsades de pointes (TdP), ventricular arrhythmias, and other relevant terms. Expert opinion: There is a paucity of available information on the QT interval for most analgesics. Of those for which there is a lot of data, only methadone, oxycodone, and LAAM (levo--acetylmethadol) appear to have a known and accepted level of effect on the QT interval.
Affiliation
Temple University School of Pharmacy , 3307 North Broad Street, Philadelphia, PA 19140 , USA +1 215 707 4976 ; +1 215 707 5228 ; robert.raffa@temple.edu.
Journal Details
This article was published in the following journal.
Name: Expert opinion on pharmacotherapy
ISSN: 1744-7666
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/22568597
- DOI: http://dx.doi.org/10.1517/14656566.2012.682150
Medical and Biotech [MESH] Definitions
Analgesia, Patient-controlled
Relief of PAIN, without loss of CONSCIOUSNESS, through ANALGESIC AGENTS administered by the patients. It has been used successfully to control POSTOPERATIVE PAIN, during OBSTETRIC LABOR, after BURNS, and in TERMINAL CARE. The choice of agent, dose, and lockout interval greatly influence effectiveness. The potential for overdose can be minimized by combining small bolus doses with a mandatory interval between successive doses (lockout interval).
Survival Rate
The proportion of survivors in a group, e.g., of patients, studied and followed over a period, or the proportion of persons in a specified group alive at the beginning of a time interval who survive to the end of the interval. It is often studied using life table methods.
Pre-excitation, Mahaim-type
A form of ventricular pre-excitation characterized by a normal PR interval and a long QRS interval with an initial slow deflection (delta wave). In this syndrome, the atrial impulse travel to the ventricle via the Mahaim fibers which connect ATRIOVENTRICULAR NODE directly to the right ventricle wall (nodoventricular pathway) or to the RIGHT BUNDLE BRANCH OF HIS (nodofascicular pathway).
Wolff-parkinson-white Syndrome
A form of ventricular pre-excitation characterized by a short PR interval and a long QRS interval with a delta wave. In this syndrome, atrial impulse conducts to the HEART VENTRICLES via an accessory pathway located between the wall of the right or left atria and the ventricles, known as the bundle of Kent. The inherited form can be caused by mutation of PRKAG2 gene encoding a gamma-2 regulatory subunit of AMP-activated protein kinase.
Wills
Legal documents that are declarations of individuals' wishes regarding the disposal of their property or estate after death; esp: written instruments, legally executed, by which dispositions are made of estates. LIVING WILLS are written declarations regarding prolongation of life by extraordinary means.
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