The effect of oral methadone on the QTc interval in advanced cancer patients: a prospective pilot study.
The effect of oral methadone on the QTc interval in advanced cancer patients: a prospective pilot study.
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口服美沙酮对晚期癌症患者 QTc 间期的影响：一项前瞻性试点研究。
DOI：
10.1089/jpm.2009.0184
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发表时间：
2010
影响因子：
2.8
通讯作者：
Bruera,Eduardo
中科院分区：
文献类型：
--
作者：
Reddy,Suresh;Hui,David;ElOsta,Badi;delaCruz,Maxine;Walker,Paul;Palmer,JLynn;Bruera,Eduardo
背景：最近的报道表明，高剂量的美沙酮可能会延长QTc间期，偶尔会导致尖端扭转型室性心动过速，然而，这些研究很少涉及姑息治疗population.Objective：本研究的目的是确定的影响美沙酮对QTc间期的癌症疼痛患者看到在姑息治疗setting.Methods：我们招募了100例癌症患者在这项前瞻性研究。在基线、2、4和8周时，对患者进行临床和心电图随访，以了解QTc变化。记录了QTc间期延长的促成因素，如药物、心血管疾病和电解质紊乱。QTc间期延长被定义为大于430毫秒的男性和大于450毫秒的女性，和显着的QTc间期延长被定义为QTc间期大于25%，从基线或500毫秒或以上。结果：心电图（ECG）评估可用于100，64，41，和27例患者在基线，2，4，和8周的后续行动，分别。在开始美沙酮治疗前的基线时，28例（28%）患者出现QTc延长。第2周时，64例患者中仅1例（1.6%）发生具有临床意义的QTc延长，第4周和第8周时均未发生。无尖端扭转型室性心动过速、室颤或猝死的临床证据。QTc间期延长是更常见的基线QTc interval.Conclusions：基线QTc间期延长是常见的，而显着的QTc间期500 ms或以上的美沙酮开始后很少发生，没有证据表明有临床意义的心律失常。这项研究支持美沙酮用于晚期癌症患者姑息治疗中疼痛控制的安全性。
Background:Recent reports suggest that high doses of methadone may prolong QTc interval and occasionally cause torsades de pointes; however, few of these studies involved the palliative care population.Objective:The purpose of this study was to determine the effect of initiation of methadone on QTc interval in patients with cancer pain seen at the palliative care setting.Methods:We enrolled 100 patients with cancer in this prospective study. Patients were followed clinically and electrocardiographically for QTc changes at baseline, 2, 4, and 8 weeks. Contributing factors for QTc prolongation such as medications, cardiovascular diseases, and electrolytes disturbances were documented. QTc prolongation was defined as greater than 430 ms in males and greater than 450 ms in females, and significant QTc prolongation was defined as QTc interval greater than 25% increase from baseline or 500 ms or more.Results:Electrocardiographic (ECG) assessments were available for 100, 64, 41, and 27 patients at baseline, 2-, 4-, and 8-week follow-up, respectively. At baseline prior to initiation of methadone, 28 (28%) patients had QTc prolongation. Clinically significant increase in QTc occurred in only 1 of 64 (1.6%) patients at week 2, and none at weeks 4 and 8. There was no clinical evidence of torsades de pointes, ventricular fibrillation, or sudden death. QTc prolongation was more frequent among patients with increased baseline QTc interval.Conclusions:Baseline QTc prolongation was common, whereas significant QTc interval 500 ms or more after methadone initiation rarely occurred, with no evidence of clinically significant arrhythmias. This study supports the safety of methadone use for pain control in patients with advanced cancer in the palliative care setting.
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DOI：
10.1001/jama.1984.03350140051025
发表时间：
1984
期刊：
JAMA
影响因子：
--
作者：
J. Ewing
通讯作者：
J. Ewing
在姑息治疗环境中管理晚期癌症引起的疼痛。
影响因子：
1.1
作者：
B. Ferrell;M. Levy;J. Paice
通讯作者：
J. Paice
阿片类药物的选择标准。
影响因子：
4.7
作者：
C. Benedetti;E. Dickerson
通讯作者：
E. Dickerson
抗凝血酶 III 在肺栓塞临床治疗中的作用。
DOI：
10.1016/0002-9343(84)90708-3
发表时间：
1984
期刊：
The American journal of medicine
影响因子：
--
作者：
R. Bick
通讯作者：
R. Bick
影响因子：
4.7
作者：
Lawlor, P;Walker, P;Mitchell, S
通讯作者：
Mitchell, S