scholarly journals Drug-induced arrhythmias

2021 ◽  
pp. 26-40
Author(s):  
M. V. Leonova
Keyword(s):  
Risk Factors ◽  
Heart Diseases ◽  
Plasma Concentrations ◽  
Interleukin 2 ◽  
Electrolyte Balance ◽  
Modifiable Risk Factors ◽  
Antineoplastic Drugs ◽  
Electrolyte Disorders ◽  
Drug Induced ◽  
Scientific Review

The article provides a scientific review based on the proceedings of the 2020 American Heart Association consensus on drugs that may cause arrhythmias on a risk-sensitive basis and a guidance on strategies for monitoring, prevention methods and therapeutic approaches.The risk factors for drug-induced arrhythmias are divided into modifiable and non-modifiable. Among the non-modifiable risk factors are congenital anomalies (changes in the conduction system, ion channel polymorphism) and heart diseases (cavity dilatation, myocardial ischemia). Among the modifiable risk factors are various electrolyte disorders (hypo/hyperkalemia, hypo/hypermagnesemia, hypocalcemia). Certain drugs can lead to electrolyte disorders, which require management with potassium and magnesium supplements. The drug-induced arrhythmias can be caused by conditions leading to altered drug pharmacokinetics and increased plasma concentrations and metabolites having proarrhythmogenic effects, as well as drug-drug interactions.Beta-blockers, non-dihydropyridine calcium channel blockers, other antiarrhythmic drugs, ivabradine, digoxin, anesthetics (bupivacaine, propofol) are the most common culprits in causing drug-induced bradyarrhythmias. The drug-induced atrial fibrillation frequently occurs in patients receiving antiarrhythmics, various sympathomimetics, psychotropic and antineoplastic drugs, anti-inflammatory (NSAIDs, corticosteroids) and immunotropic agents (interleukin-2, fingolimod). Various sympathomimetics and inotropic drugs, some antipsychotic drugs can produce drug-induced atrial and nodal tachyarrhythmias.The drug-induced ventricular tachycardia can be caused by antiarrhythmics, inotropics and various sympathomimetics, antipsychotic and antineoplastic drugs, as well as herbal drugs (aconite, ginkgo biloba). The list of drugs that cause a long QT syndrome includes antiarrhythmics, antimicrobial drugs (macrolides, fluoroquinolones, aminoquinolines, fluconazole), antipsychotics, antineoplastic drugs, antiemetics, etc. For a complete list of drugs that prolong a QT interval, see the CredibleMeds website (Arizona, USA). The drug-induced arrhythmia prevention strategies include rising awareness among doctors about risk factors and potentially dangerous drugs, sufficient monitoring of patients at risk of developing arrhythmias (ECG monitoring, electrolyte balance, kidney and liver function), maintenance of electrolyte balance, primarily potassium and magnesium. The therapeutic approach includes discontinuation of a causative drug; relief and maintenance therapy are carried out based on the modern international clinical guidelines for various forms of arrhythmias. 

Drugs associated with drug-induced hyponatremia

2021 ◽  
pp. 92-99
Author(s):  
A. I. Listratov ◽  
A. G. Komarova ◽  
E. V. Aleshckovich ◽  
M. V. Velichcko ◽  
O. D. Ostroumova
Keyword(s):  
Risk Factors ◽  
Sodium Level ◽  
Clinical Manifestations ◽  
Opioid Analgesics ◽  
Electrolyte Balance ◽  
Antineoplastic Drugs ◽  
Drug Induced ◽  
Low Sodium ◽  
Significant Disturbance ◽  
Fatal Complications

Hyponatremia (HN) is a significant disturbance of the water-electrolyte balance in clinical practice. Drugs are one of the leading causes of low sodium level. Antidepressants, antiepileptic, antipsychotic, antineoplastic drugs and opioid analgesics are the most common medications that induce hyponatremia. Special attention should be paid to people with cancer, who often receive several drugs that induce HN. Risk factors for the development of drug-induced (DI) HN when taking most medications are female sex, weight loss, and old age. In persons receiving therapy with the listed drugs, it is necessary to assess the risk factors for a decrease in the sodium level, clinical manifestations from the nervous system, and to determine the sodium level in dynamics. Special care must be taken when treating elderly patients, since they have several risk factors for the development of DI HN. These measures will help prevent the development of HN and its severe and sometimes fatal complications.

scholarly journals Prevalence of Modifiable Risk Factors among Stroke Patients in a Tertiary Care Hospital in Dhaka

1970 ◽  
pp. 18-21 ◽  
Author(s):  
Md Badiuzzaman ◽  
Fazle Rabbi Mohammed ◽  
Fazle Rabbi Chowdhury ◽  
Md Shafiqul Bari ◽  
Md Billal Alam ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Heart Diseases ◽  
Tertiary Care ◽  
Modifiable Risk Factors ◽  
Care Hospital ◽  
Stroke Patients ◽  
Female Ratio ◽  
History Of ◽  
Arachnoid Hemorrhage

Background: An event of stroke can be ignited by a number of risk factors, some of which are nonmodifiable and some are modifiable. Hypertension, diabetes mellitus, different heart diseases, hyperlipidemia and smoking belong to the latter group and their prevalence shows immense diversity worldwide. In this study we tried to identify the most prevalent risk factor for stroke. Categorization of various types of stroke and history of noncompliance in medication has also been evaluated. Methods: This direct observational study was carried out on 400 patients of stroke admitted in different medicine units of Dhaka Medical College Hospital from July to December, 2007. Only patients having clinical diagnosis of stroke, confirmed by CT scan or MRI, were recruited. Patients were grouped into ischemic or hemorrhagic stroke or sub arachnoid hemorrhage. Results: The male, female ratio was found 1.2:1. In the study cerebral infraction, intra cerebral hemorrhages (ICH) and sub arachnoid hemorrhage (SAH) were found in 56.25%, 38.25% and 5.5% patients respectively. In case of Ischemic stroke and ICH males were predominantly affected but in case of SAH females were predominant. Among patients, hypertension was found in 58.62% followed by smoking (53.79%), lipid disorder (48.01%), heart diseases (25.75%), diabetes mellitus (20.01%), and previous history of stroke (10.61%). 40% patients were on irregular use of antihypertensive drug and it was 17.5% in case of anti diabetic drugs. Major groups (42.44%) of patients have two modifiable risk factors. Conclusion: Stroke is better to prevent than to cure. Identification of risk factors is the only way to achieve this goal. Implementation of screening programme in community to identify risk factors and educate people about primary prevention should be initiated in this regard. This way, we can reduce morbidity and mortality among stroke patients and alleviate the burden of stroke.   doi:10.3329/jom.v10i3.2011   J Medicine 2009; 10 (Supplement 1): 18-21

Drug-induced atrioventricular blockages

2020 ◽  
Vol 1 (19) ◽  
pp. 56-64
Author(s):  
M. I. Kulikova ◽  
O. D. Ostroumova ◽  
A. G. Komarova
Keyword(s):  
Risk Factors ◽  
Heart Rhythm ◽  
Inhibitory Effect ◽  
Antineoplastic Drugs ◽  
Av Node ◽  
Drug Induced ◽  
Treatment And Prevention ◽  
Av Conduction ◽  
Common Risk Factors ◽  
Conduction Disorder

Atrio-ventricular (AV) blockages are a serious violation of the heart rhythm. One of the reasons for the development of this pathology may be taking medications. This effect has a significant number of drugs used for the treatment of diseases of the cardiovascular system, central nervous system, general and local anesthetics, antineoplastic drugs, and many others. The main mechanism for the development of drug-induced AV blockades is the inhibition of AV node conduction. The most common risk factors for the development of drug-induced AV blockades are taking two and more drugs that have an inhibitory effect on AV conduction, the initial duration of the PQ interval more than 0.2 second, initial dysfunction of the AV node, increased plasma concentration of a potential inducer drug due to the presence of kidney and/or liver disease, drugdrug interactions, and specific risk factors for individual drugs. Special attention in solving this problem should be paid to both stopping the developed AV conduction disorder – medication or using an electric cardiostimulator, and its prevention. This article systematizes the literature data on drug-induced AV blockades in order to increase the awareness of practitioners and patients about their prevalence, risk factors, approaches to diagnosis, treatment and prevention.

Prevalence of Modifiable Risk Factors among Stroke Patients in Tertiary Care Hospital

2021 ◽  
Vol 15 (9) ◽  
pp. 4005-4008
Author(s):  
Muhammad Sohrab Khan ◽  
Rahmat Ali ◽  
Shakeel Ahmad ◽  
Tahir Mukhtar Sayed
Keyword(s):  
Risk Factors ◽  
Stroke Prevention ◽  
Heart Diseases ◽  
Ischemic Heart ◽  
Smoking History ◽  
Modifiable Risk Factors ◽  
Care Hospital ◽  
Stroke Patients ◽  
Female Ratio ◽  
Cholesterol Levels

Background: A stroke can either be modifiable or non-modifiable triggered by various risk factors. Globally, modifiable stroke could ignite in the form of diabetes, smoking, hypertension, hyperlipidemia, and various heart diseases Aim: The present study intended to evaluate the prevalence of modifiable risk factors in stroke patients Methods: This cross-sectional study was conducted on 182 stroke patients admitted to the Medicine Department of TCH name from January 2021 to October 2021. Clinically diagnosed stroke patients of age 20 years or above confirmed by magnetic resonance imaging (MRI) or computed tomography (CT) were enrolled. Demographic details, previous medical history, and concerns investigation were gathered in pre-designed proforma. For data analysis, SPSS version 20 was used Results: The overall mean age of the 182stroke patients was 58.43±9.45 years with an age range from 20 years to 85years. Of the total 182 patients, 104 (57.1%) were male and 78 (42.9%) were female. The male to female ratio was 1.33:1. The prevalence of stroke types such as subarachnoid hemorrhage, cerebral infraction, and intracerebral hemorrhages was 4.5%, 58.4%, and 37.1% respectively. The incidence of risk factors such as ischemic heart disease, previous stroke, high cholesterol levels, smoking history, diabetes, and hypertension was 11 (6.04%), 18 (9.9%), 24 (13.2%), 33 (18.1%),38 (20.9%), and 113 (62.1%) respectively Conclusion: Our study found that hypertension is the major modifiable risk factor for stroke development followed by other risk factors such as diabetes, higher cholesterol levels, smoking history, and ischemic heart diseases. Also, it has been observed that stroke prevention is better than cure by identifying various risk factors and initiation of stroke prevention education. Controlling modifiable risk factors mitigate the mortality rate among stroke patients. Keywords: Ischemic Stroke; Modifiable Risk factors; Hemorrhagic Stroke

Drugs associated with drug-induced hyponatremia. Focus on antihypertensive drugs and proton pump inhibitors

2021 ◽  
Vol 1 (29) ◽  
pp. 40-46
Author(s):  
A. I. Listratov ◽  
E. V. Aleshckovich ◽  
O. D. Ostroumova
Keyword(s):  
Risk Factors ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Sodium Level ◽  
Antihypertensive Drugs ◽  
Clinical Manifestations ◽  
Electrolyte Disorders ◽  
Drug Induced ◽  
Effective Prevention ◽  
History Of

Hyponatremia (HN) is one of the leading water-electrolyte disorders in daily medical practice. A decrease in sodium level is dangerous with the development of various complications. Therefore, for effective prevention of HN and its complications, special attention should be paid to modifiable risk factors. One of the important causes leading to HN is drugs. Most often, HN develops during therapy with thiazide and thiazidelike diuretics. Risk factors for its development are history of thiazide-induced HN, advanced age, female sex, low body weight, and hypokalemia. The problem of thiazide-induced HN requires further study of the pathogenetic mechanisms and determination of the genetic factors underlying it. It is also necessary to remember about the possibility of HN development against the background of such drugs widely used in therapeutic practice as blockers of the renin-angiotensin-aldosterone system and proton pump inhibitors. In patients receiving therapy with the listed drugs, it is necessary to pay attention to the possible clinical manifestations of HN and to determine the sodium level in dynamics, which will effectively prevent the development of this disorder.

Predicting attrition in long-term residential substance use disorder treatment: A modifiable risk factors perspective.

2020 ◽  
Vol 17 (4) ◽  
pp. 472-482
Author(s):  
Danielle E. Baker ◽  
Keith A. Edmonds ◽  
Maegan L. Calvert ◽  
Sarah M. Sanders ◽  
Ana J. Bridges ◽  
...  
Keyword(s):  
Risk Factors ◽  
Substance Use ◽  
Substance Use Disorder ◽  
Modifiable Risk Factors ◽  
Substance Use Disorder Treatment ◽  
Disorder Treatment

Controlling Hypertension and Stroke Prevention – From Guideline to Clinical Practice

2011 ◽  
Vol 3 (1) ◽  
pp. 30
Author(s):  
Anding Xu ◽  
Zefeng Tan ◽  
◽  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Clinical Trials ◽  
Clinical Practice ◽  
Stroke Prevention ◽  
Modifiable Risk Factors ◽  
Cerebrovascular Events

Hypertension is the most important of the prevalent and modifiable risk factors for stroke. Based on evidence, blood pressure (BP) lowering is recommended in guidelines for the prevention of stroke. However, there are still some uncertainties in the guidelines for controlling BP and preventing stroke in patients with previous cerebrovascular events, such as the goal BP, who to treat and which class of BP-lowering drugs to use. This article discusses these questions by reviewing guidelines and corresponding clinical trials, with the aim of reducing the gap between guidelines and clinical practice.

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