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首页> 外文期刊>The Canadian journal of hospital pharmacy. >Domperidone-Associated QT Interval Prolongation in Non-oncologic Pediatric Patients: A Review of the Literature
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Domperidone-Associated QT Interval Prolongation in Non-oncologic Pediatric Patients: A Review of the Literature

机译：非肿瘤学科患者的DOMPERIDONE相关的QT间隔延长：对文献的综述

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Background: Domperidone is a prokinetic agent used to treat pediatric gastroesophageal reflux disease. Health Canada has issued warnings about an increased risk of domperidone-associated ventricular arrhythmias and sudden cardiac death. However, the supporting data referred only to adult patients; therefore, extrapolating the safety risks to pediatric patients is difficult. Objective: To summarize and evaluate the evidence for domperidone-associated QT interval prolongation, ventricular arrhythmias, and sudden cardiac death to determine the safety of this drug for pediatric patients. Data Sources: Two databases (MEDLINE [1946 to August 2015] and Embase [1980 to August 2015]) were searched with the following Medical Subject Headings and keywords: "domperidone", "arrhythmias, cardiac", "death, sudden, cardiac", "electrocardiography", "heart diseases", "long QT syndrome", "tachycardia, ventricular", "torsades de pointes", and "ventricular fibrillation". The search was limited to studies conducted in humans under 18 years of age and published in English. Study Selection and Data Extraction: Original research included in this review reported on the cardiac-related safety of domperidone in non-oncologic patients under 18 years of age. Data Synthesis: Of the 5 studies meeting the inclusion criteria (n = 137 patients), one reported a statistically significant change in the corrected QT (QTc) interval, but the clinical significance was unclear. Most of the studies reported rare occurrences of pathological QTc intervals in a limited number of patients. However, confounding factors (e.g., abnormal electrolyte level or concurrent medications) were not consistently considered. Potential bias might have been alleviated by blinding of electrocardiogram (ECG) assessors; however, this was not consistently implemented. The designs of the included studies did not allow assessment of causality. The results should be interpreted with caution. Conclusions: Although the available evidence is limited, pathological QTc intervals were noted among a small number of infants, which supports the possibility of domperidone-associated risk of prolonged QTc interval. Because of the potential severity of QT interval prolongation, individual assessment and routine ECG monitoring should be implemented for patients receiving domperidone.
机译：背景：Domperidone是一种用于治疗儿科胃食管反流疾病的动力药剂。卫生加拿大发出警告，了解多人生相关的心律失常和突发心脏死亡风险。但是，支持数据仅提及成年患者;因此，将安全风险推断到儿科患者是困难的。目的：总结和评价Doperidone相关的QT间隔延长，心间心律失常和突发性心脏死亡的证据，以确定该药物对儿科患者的安全性。数据来源：两个数据库（MEDLINE [1946年至2015年8月]和EMBASE [1980年至2015年8月]）被以下医学主题标题和关键词搜索：“DOMPERIDONE”，“心律失常，心脏”，“死亡，突然，心脏” ，“心电图”，“心脏病”，“长QT综合征”，“心动过缓，心室”，“扭曲DE点”，和“心室颤动”。该搜索仅限于18岁以下的人类进行的研究，并用英语发表。研究选择和数据提取：本综述中包含的原始研究报告了18岁以下的非肿瘤学患者的COMPARIDONE的心脏相关安全性。数据合成：在满足纳入标准的5研究中（n = 137名患者），据报道矫正QT（QTC）间隔的统计学显着变化，但临床意义尚不清楚。大多数研究报告称在有限数量的患者中罕见的病理QTC间隔。然而，不始终考虑混淆因素（例如，电解质水平或并发药物）。潜在的偏见可能已经通过心电图（ECG）评估员的致盲来缓解;但是，这并不一致地实施。所包含的研究的设计不允许评估因果关系。结果应谨慎解释。结论：尽管可用的证据是有限的，但在少数婴儿中指出了病理QTC间隔，该间隔支持多培养酮相关QTC间隔的可能性。由于Qt间隔延长的潜在严重程度，应为接受DOMPERIDONE的患者实施个体评估和常规ECG监测。

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