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.

Drug-induced seizures: prevalence, risk factors, treatment and prevention

2019 ◽  
Vol 119 (11) ◽  
pp. 86 ◽  
Author(s):  
T. M. Ostroumova ◽  
O. D. Ostroumova ◽  
E. S. Akimova ◽  
A. I. Kochetkov
Keyword(s):  
Risk Factors ◽  
Drug Induced ◽  
Treatment And Prevention ◽  
Drug Induced Seizures

scholarly journals Drug-Induced Atrial Fibrillation / Atrial Flutter

2022 ◽  
Vol 17 (6) ◽  
pp. 1-18
Author(s):  
O. D Ostroumova ◽  
M. S. Chernyaeva ◽  
A. I. Kochetkov ◽  
A. E. Vorobieva ◽  
D. I. Bakhteeva ◽  
...  
Keyword(s):  
Risk Factors ◽  
Atrial Fibrillation ◽  
Differential Diagnosis ◽  
Holter Monitoring ◽  
Clinical Situation ◽  
Drug Induced ◽  
Self Monitoring ◽  
Conduction Disturbances ◽  
Treatment And Prevention ◽  
Life Threatening

Drug-induced atrial fibrillation / flutter (DIAF) is a serious and potentially life-threatening complication of pharmacotherapy. Purpose of the work: systematization and analysis of scientific literature data on drugs, the use of which can cause the development of DIAF, as well as on epidemiology, pathophysiological mechanisms, risk factors, clinical picture, diagnosis and differential diagnosis, treatment and prevention of DIAF. Analysis of the literature has shown that many groups of drugs can cause the development of DIAF, with a greater frequency while taking anticancer drugs, drugs for the treatment of the cardiovascular, bronchopulmonary and central nervous systems. The mechanisms and main risk factors for the development of DIAF have not been finally established and are known only for certain drugs, therefore, this section requires further study. The main symptoms of DIAF are due to the severity of tachycardia and their influence on the parameters of central hemodynamics. For diagnosis, it is necessary to conduct an electrocardiogram (ECG) and Holter monitoring of an ECG and echocardiography. Differential diagnosis should be made with AF, which may be caused by other causes, as well as other rhythm and conduction disturbances. Successful treatment of DIAF is based on the principle of rapid recognition and immediate discontinuation of drugs (if possible), the use of which potentially caused the development of adverse drug reactions (ADR). The choice of management strategy: heart rate control or rhythm control, as well as the method of achievement (medication or non-medication), depends on the specific clinical situation. For the prevention of DIAF, it is necessary to instruct patients about possible symptoms and recommend self-monitoring of the pulse. It is important for practitioners to be wary of the risk of DIAF due to the variety of drugs that can potentially cause this ADR.

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 Drug-induced long QT interval: prevalence, risk factors, treatment and prevention

2019 ◽  
Vol 21 (3) ◽  
pp. 62-67
Author(s):  
Olga D. Ostroumova ◽  
◽  
Irina V. Goloborodova ◽  
◽  
Keyword(s):  
Risk Factors ◽  
Qt Interval ◽  
Long Qt ◽  
Drug Induced ◽  
Treatment And Prevention ◽  
Long Qt Interval

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. 

Antineoplastic drugs and drug-induced liver damage with cholestasis

2020 ◽  
Vol 1 (19) ◽  
pp. 47-54 ◽  
Author(s):  
A. P. Pereverzev ◽  
O. D. Ostroumova
Keyword(s):  
Alkylating Agents ◽  
Interleukin 1 ◽  
Clinical Manifestations ◽  
Antineoplastic Drugs ◽  
Targeted Drugs ◽  
Drug Induced ◽  
Drug Induced Liver Injury ◽  
Treatment And Prevention ◽  
The Russian Federation ◽  
Novel Drug

The number of cases of drug-induced liver injury (DILI) has been increasing since the 1990s. DILIs cause up to 40,000 deaths each year. One of the leaders in the number of DILIs are antineoplastic drugs ms, such as alkylating agents, antimetabolites, targeted drugs, monoclonal antibodies, etc. One of the most effective and safe strategies for the treatment and prevention of DILI is to use hepatoprotective drugs. Currently, on the market of the Russian Federation, is available novel drug Heptrong® (does not have an International Non-proprietary Name), which has anti-inflammatory, antioxidant activity and the ability to stabilize and reduce the permeability of hepatocyte membranes, suppress the activity 5-lipoxygenase, a decrease in the synthesis of leukotriene B4, interleukin-1, interleukin-6, which are pro-inflammatory cytokines. The drug activates the antitoxic function of the liver, improves its protein- and lipid-synthesizing functions. Heptrong® neutralizes the processes of inflammation in the liver, thereby reducing the severity of the clinical manifestations of drug-induced lesions.

scholarly journals Lung Injury Induced by Antitumor Drugs: Diagnosis, Features of the Clinical Course, Risk Factors, Differential Diagnosis, Treatment, and Prevention. Part 1

2021 ◽  
Vol 99 (7) ◽  
pp. 55-62
Author(s):  
N. V. Orlovа ◽  
O. D. Ostroumovа ◽  
E. V. Shikh ◽  
S. V. Smerdin ◽  
E. V. Rebrovа ◽  
...  
Keyword(s):  
Risk Factors ◽  
Differential Diagnosis ◽  
Early Diagnosis ◽  
Lung Injury ◽  
Tobacco Smoking ◽  
Clinical Course ◽  
Antitumor Drugs ◽  
Drug Induced ◽  
Duration Of Therapy ◽  
Treatment And Prevention

57 publications on pneumotoxicity of antitumor drugs were analyzed. It was found that the development of pneumotoxic effects could be influenced by risk factors such as gender, age, tobacco smoking, comorbidities, and duration of therapy. Symptoms of lung injury induced by antitumor drugs are nonspecific thus it is difficult to diagnose them promptly. For prevention, early diagnosis and timely management of drug-induced lung injury during antineoplastic therapy, it is necessary to raise awareness of such a condition in practitioners of different specialties, primarily general practitioners, pulmonologists, phthisiologists, and oncologists.

scholarly journals Sulfamethoxazole-induced sulfamethoxazole urolithiasis: a case report

BMC Urology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Megan M. Roedel ◽  
Stephen Y. Nakada ◽  
Kristina L. Penniston
Keyword(s):  
Risk Factors ◽  
Case Report ◽  
Urinary Calculi ◽  
Laser Lithotripsy ◽  
Stone Disease ◽  
High Dose ◽  
Drug Induced ◽  
Treatment And Prevention ◽  
Associated Risk Factors ◽  
Prevention Methods

Abstract Background Drug-induced urolithiasis falls into two categories: drug-induced and metabolically-induced. Certain antimicrobials are associated with each; sulfonamides are associated with drug- or metabolite-containing calculi when taken in large doses over a long period of time. Trimethoprim-sulfamethoxazole, a member of the sulfonamide family, is a rare cause of drug-induced calculi. Cases of sulfonamide urolithiasis occurring in patients with known stone disease have rarely been reported. Case presentation We report a case of a patient with a brief history of recurrent calcium oxalate nephrolithiasis requiring 2 ureteroscopic procedures whose existing 6 mm lower pole renal stone more than quadrupled in size to form a 4 cm renal staghorn after 4 months of high-dose treatment for Nocardia pneumonia with trimethoprim-sulfamethoxazole. After ureteroscopy with laser lithotripsy and basketing of fragments, the stone was found to be predominantly composed of N4-acetyl-sulfamethoxazole, a metabolite of sulfamethoxazole. Conclusion Stones composed of sulfamethoxazole or its metabolites are rare but have known associated risk factors that should be considered when prescribing this antibiotic. This case report illustrates additional risk factors for consideration, including pre-existing urinary calculi that may serve as a nidus for sulfamethoxazole deposition, and reviews treatment and prevention methods.

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