Dextrophropoxyphene effects on QTc-interval prolongation: Frequency and characteristics in relation to plasma levels

Autores
Keller, Guillermo Alberto; Villa Etchegoyen, Cecilia; Fernandez, Nicolas; Olivera, Nancy Monica; Quiroga, Patricia Noemí; Diez, Roberto Alejandro; Di Girolamo, Guillermo
Año de publicación
2018
Idioma
inglés
Tipo de recurso
artículo
Estado
versión publicada
Descripción
Objective: To evaluate frequency and risk factors for dextropropoxypheneinduced QT-interval prolongation in the clinical setting. Design: Prospective, noninterventional, observational, longitudinal cohort approach. Electrocardiograms were blindly evaluated by independent professionals. Setting: General ward of a public hospital of metropolitan Buenos Aires. Patients, Participants: Ninety-two patients with indication of receiving dextropropoxyphene for analgesic purposes were included consecutively. All patients finished the study. Interventions: All patients were monitored with electrocardiographic controls (previous to drug administration and during steady state) to diagnose and quantify changes in the duration of the QTc interval. Main Outcome Measure: Frequency of drug-induced QTc interval prolongation, QTc interval correlation with plasma drug, and metabolite levels. Results: Ninety-two patients were studied (50 percent males). All patients received a (mean ± SD [range]) dextropropoxyphene dose of 125 ± 25[100-150] mg/d. Dextropropoxyphene and norpropoxyphene concentrations were 112 ± 38[45-199] and 65 ± 33[13-129] ng/mL, respectively. The intra-treatment QTc interval was >450 ms in only one patient (only with the Hodge correction). There were no cases of QTc > 500 ms, and there were no significant differences in the results considering different correction formulas (Bazzet, Fridericia, Framingham, Hodges). Dextropropoxyphene concentrations correlated with QTc (R > 0.45) interval and ΔQTc (R 0.52-0.87), whereas norpropoxyphene correlation was even greater for QTc (R > 0.40-0.64) and ΔQTc (R > 0.47-0.92). Depending on the QTc correction formula, eight patients presented ΔQTc > 30 ms and one patient with ΔQTc > 60 ms. No patient presented arrhythmia during the study. Conclusions: The authors did not observe a relationship between dextropropoxyphene and QTc interval prolongation at the therapeutic doses used in Argentina.
Fil: Keller, Guillermo Alberto. Gobierno de la Ciudad de Buenos Aires. Hospital de Agudos "D. F. Santojanni"; Argentina. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Farmacología; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina
Fil: Villa Etchegoyen, Cecilia. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Laboratorio de Toxicología y Química Legal; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina
Fil: Fernandez, Nicolas. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Laboratorio de Toxicología y Química Legal; Argentina
Fil: Olivera, Nancy Monica. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Laboratorio de Toxicología y Química Legal; Argentina
Fil: Quiroga, Patricia Noemí. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Laboratorio de Toxicología y Química Legal; Argentina
Fil: Diez, Roberto Alejandro. Universidad de Buenos Aires. Facultad de Medicina. Departamento de Farmacología; Argentina
Fil: Di Girolamo, Guillermo. Consejo Nacional de Investigaciones Cientificas y Tecnicas. Oficina de Coordinacion Administrativa Houssay. Instituto Alberto C. Taquini de Investigaciones En Medicina Traslacional. - Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Cardiologicas "prof. Dr. Alberto C. Taquini". Instituto Alberto C. Taquini de Investigaciones En Medicina Traslacional.; Argentina
Materia
ADVERSE DRUG REACTION
ARRHYTHMIA
DEXTROPHROPOXYPHENE
QT-INTERVAL PROLONGATION
TORSADE DE POINTES
Nivel de accesibilidad
acceso abierto
Condiciones de uso
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
Repositorio
CONICET Digital (CONICET)
Institución
Consejo Nacional de Investigaciones Científicas y Técnicas
OAI Identificador
oai:ri.conicet.gov.ar:11336/177837
Acceder
id CONICETDig_8874885d67dea81c40d4c7cdce142ac3
oai_identifier_str oai:ri.conicet.gov.ar:11336/177837
network_acronym_str CONICETDig
repository_id_str 3498
network_name_str CONICET Digital (CONICET)
spelling Dextrophropoxyphene effects on QTc-interval prolongation: Frequency and characteristics in relation to plasma levelsKeller, Guillermo AlbertoVilla Etchegoyen, CeciliaFernandez, NicolasOlivera, Nancy MonicaQuiroga, Patricia NoemíDiez, Roberto AlejandroDi Girolamo, GuillermoADVERSE DRUG REACTIONARRHYTHMIADEXTROPHROPOXYPHENEQT-INTERVAL PROLONGATIONTORSADE DE POINTEShttps://purl.org/becyt/ford/3.1https://purl.org/becyt/ford/3Objective: To evaluate frequency and risk factors for dextropropoxypheneinduced QT-interval prolongation in the clinical setting. Design: Prospective, noninterventional, observational, longitudinal cohort approach. Electrocardiograms were blindly evaluated by independent professionals. Setting: General ward of a public hospital of metropolitan Buenos Aires. Patients, Participants: Ninety-two patients with indication of receiving dextropropoxyphene for analgesic purposes were included consecutively. All patients finished the study. Interventions: All patients were monitored with electrocardiographic controls (previous to drug administration and during steady state) to diagnose and quantify changes in the duration of the QTc interval. Main Outcome Measure: Frequency of drug-induced QTc interval prolongation, QTc interval correlation with plasma drug, and metabolite levels. Results: Ninety-two patients were studied (50 percent males). All patients received a (mean ± SD [range]) dextropropoxyphene dose of 125 ± 25[100-150] mg/d. Dextropropoxyphene and norpropoxyphene concentrations were 112 ± 38[45-199] and 65 ± 33[13-129] ng/mL, respectively. The intra-treatment QTc interval was >450 ms in only one patient (only with the Hodge correction). There were no cases of QTc > 500 ms, and there were no significant differences in the results considering different correction formulas (Bazzet, Fridericia, Framingham, Hodges). Dextropropoxyphene concentrations correlated with QTc (R > 0.45) interval and ΔQTc (R 0.52-0.87), whereas norpropoxyphene correlation was even greater for QTc (R > 0.40-0.64) and ΔQTc (R > 0.47-0.92). Depending on the QTc correction formula, eight patients presented ΔQTc > 30 ms and one patient with ΔQTc > 60 ms. No patient presented arrhythmia during the study. Conclusions: The authors did not observe a relationship between dextropropoxyphene and QTc interval prolongation at the therapeutic doses used in Argentina.Fil: Keller, Guillermo Alberto. Gobierno de la Ciudad de Buenos Aires. Hospital de Agudos "D. F. Santojanni"; Argentina. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Farmacología; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Villa Etchegoyen, Cecilia. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Laboratorio de Toxicología y Química Legal; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Fernandez, Nicolas. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Laboratorio de Toxicología y Química Legal; ArgentinaFil: Olivera, Nancy Monica. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Laboratorio de Toxicología y Química Legal; ArgentinaFil: Quiroga, Patricia Noemí. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Laboratorio de Toxicología y Química Legal; ArgentinaFil: Diez, Roberto Alejandro. Universidad de Buenos Aires. Facultad de Medicina. Departamento de Farmacología; ArgentinaFil: Di Girolamo, Guillermo. Consejo Nacional de Investigaciones Cientificas y Tecnicas. Oficina de Coordinacion Administrativa Houssay. Instituto Alberto C. Taquini de Investigaciones En Medicina Traslacional. - Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Cardiologicas "prof. Dr. Alberto C. Taquini". Instituto Alberto C. Taquini de Investigaciones En Medicina Traslacional.; ArgentinaWeston Medical Publishing2018-09info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttp://purl.org/coar/resource_type/c_6501info:ar-repo/semantics/articuloapplication/pdfapplication/pdfapplication/pdfapplication/pdfhttp://hdl.handle.net/11336/177837Keller, Guillermo Alberto; Villa Etchegoyen, Cecilia; Fernandez, Nicolas; Olivera, Nancy Monica; Quiroga, Patricia Noemí; et al.; Dextrophropoxyphene effects on QTc-interval prolongation: Frequency and characteristics in relation to plasma levels; Weston Medical Publishing; Journal of Opioid Management; 14; 5; 9-2018; 335-3441551-74892375-0146CONICET DigitalCONICETenginfo:eu-repo/semantics/altIdentifier/url/https://www.wmpllc.org/ojs/index.php/jom/article/view/2013info:eu-repo/semantics/altIdentifier/doi/10.5055/jom.2018.0466info:eu-repo/semantics/openAccesshttps://creativecommons.org/licenses/by-nc-sa/2.5/ar/reponame:CONICET Digital (CONICET)instname:Consejo Nacional de Investigaciones Científicas y Técnicas2025-09-29T09:44:06Zoai:ri.conicet.gov.ar:11336/177837instacron:CONICETInstitucionalhttp://ri.conicet.gov.ar/Organismo científico-tecnológicoNo correspondehttp://ri.conicet.gov.ar/oai/requestdasensio@conicet.gov.ar; lcarlino@conicet.gov.arArgentinaNo correspondeNo correspondeNo correspondeopendoar:34982025-09-29 09:44:06.939CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicasfalse
dc.title.none.fl_str_mv Dextrophropoxyphene effects on QTc-interval prolongation: Frequency and characteristics in relation to plasma levels
title Dextrophropoxyphene effects on QTc-interval prolongation: Frequency and characteristics in relation to plasma levels
spellingShingle Dextrophropoxyphene effects on QTc-interval prolongation: Frequency and characteristics in relation to plasma levels
Keller, Guillermo Alberto
ADVERSE DRUG REACTION
ARRHYTHMIA
DEXTROPHROPOXYPHENE
QT-INTERVAL PROLONGATION
TORSADE DE POINTES
title_short Dextrophropoxyphene effects on QTc-interval prolongation: Frequency and characteristics in relation to plasma levels
title_full Dextrophropoxyphene effects on QTc-interval prolongation: Frequency and characteristics in relation to plasma levels
title_fullStr Dextrophropoxyphene effects on QTc-interval prolongation: Frequency and characteristics in relation to plasma levels
title_full_unstemmed Dextrophropoxyphene effects on QTc-interval prolongation: Frequency and characteristics in relation to plasma levels
title_sort Dextrophropoxyphene effects on QTc-interval prolongation: Frequency and characteristics in relation to plasma levels
dc.creator.none.fl_str_mv Keller, Guillermo Alberto
Villa Etchegoyen, Cecilia
Fernandez, Nicolas
Olivera, Nancy Monica
Quiroga, Patricia Noemí
Diez, Roberto Alejandro
Di Girolamo, Guillermo
author Keller, Guillermo Alberto
author_facet Keller, Guillermo Alberto
Villa Etchegoyen, Cecilia
Fernandez, Nicolas
Olivera, Nancy Monica
Quiroga, Patricia Noemí
Diez, Roberto Alejandro
Di Girolamo, Guillermo
author_role author
author2 Villa Etchegoyen, Cecilia
Fernandez, Nicolas
Olivera, Nancy Monica
Quiroga, Patricia Noemí
Diez, Roberto Alejandro
Di Girolamo, Guillermo
author2_role author
author
author
author
author
author
dc.subject.none.fl_str_mv ADVERSE DRUG REACTION
ARRHYTHMIA
DEXTROPHROPOXYPHENE
QT-INTERVAL PROLONGATION
TORSADE DE POINTES
topic ADVERSE DRUG REACTION
ARRHYTHMIA
DEXTROPHROPOXYPHENE
QT-INTERVAL PROLONGATION
TORSADE DE POINTES
purl_subject.fl_str_mv https://purl.org/becyt/ford/3.1
https://purl.org/becyt/ford/3
dc.description.none.fl_txt_mv Objective: To evaluate frequency and risk factors for dextropropoxypheneinduced QT-interval prolongation in the clinical setting. Design: Prospective, noninterventional, observational, longitudinal cohort approach. Electrocardiograms were blindly evaluated by independent professionals. Setting: General ward of a public hospital of metropolitan Buenos Aires. Patients, Participants: Ninety-two patients with indication of receiving dextropropoxyphene for analgesic purposes were included consecutively. All patients finished the study. Interventions: All patients were monitored with electrocardiographic controls (previous to drug administration and during steady state) to diagnose and quantify changes in the duration of the QTc interval. Main Outcome Measure: Frequency of drug-induced QTc interval prolongation, QTc interval correlation with plasma drug, and metabolite levels. Results: Ninety-two patients were studied (50 percent males). All patients received a (mean ± SD [range]) dextropropoxyphene dose of 125 ± 25[100-150] mg/d. Dextropropoxyphene and norpropoxyphene concentrations were 112 ± 38[45-199] and 65 ± 33[13-129] ng/mL, respectively. The intra-treatment QTc interval was >450 ms in only one patient (only with the Hodge correction). There were no cases of QTc > 500 ms, and there were no significant differences in the results considering different correction formulas (Bazzet, Fridericia, Framingham, Hodges). Dextropropoxyphene concentrations correlated with QTc (R > 0.45) interval and ΔQTc (R 0.52-0.87), whereas norpropoxyphene correlation was even greater for QTc (R > 0.40-0.64) and ΔQTc (R > 0.47-0.92). Depending on the QTc correction formula, eight patients presented ΔQTc > 30 ms and one patient with ΔQTc > 60 ms. No patient presented arrhythmia during the study. Conclusions: The authors did not observe a relationship between dextropropoxyphene and QTc interval prolongation at the therapeutic doses used in Argentina.
Fil: Keller, Guillermo Alberto. Gobierno de la Ciudad de Buenos Aires. Hospital de Agudos "D. F. Santojanni"; Argentina. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Farmacología; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina
Fil: Villa Etchegoyen, Cecilia. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Laboratorio de Toxicología y Química Legal; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina
Fil: Fernandez, Nicolas. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Laboratorio de Toxicología y Química Legal; Argentina
Fil: Olivera, Nancy Monica. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Laboratorio de Toxicología y Química Legal; Argentina
Fil: Quiroga, Patricia Noemí. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Laboratorio de Toxicología y Química Legal; Argentina
Fil: Diez, Roberto Alejandro. Universidad de Buenos Aires. Facultad de Medicina. Departamento de Farmacología; Argentina
Fil: Di Girolamo, Guillermo. Consejo Nacional de Investigaciones Cientificas y Tecnicas. Oficina de Coordinacion Administrativa Houssay. Instituto Alberto C. Taquini de Investigaciones En Medicina Traslacional. - Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Cardiologicas "prof. Dr. Alberto C. Taquini". Instituto Alberto C. Taquini de Investigaciones En Medicina Traslacional.; Argentina
description Objective: To evaluate frequency and risk factors for dextropropoxypheneinduced QT-interval prolongation in the clinical setting. Design: Prospective, noninterventional, observational, longitudinal cohort approach. Electrocardiograms were blindly evaluated by independent professionals. Setting: General ward of a public hospital of metropolitan Buenos Aires. Patients, Participants: Ninety-two patients with indication of receiving dextropropoxyphene for analgesic purposes were included consecutively. All patients finished the study. Interventions: All patients were monitored with electrocardiographic controls (previous to drug administration and during steady state) to diagnose and quantify changes in the duration of the QTc interval. Main Outcome Measure: Frequency of drug-induced QTc interval prolongation, QTc interval correlation with plasma drug, and metabolite levels. Results: Ninety-two patients were studied (50 percent males). All patients received a (mean ± SD [range]) dextropropoxyphene dose of 125 ± 25[100-150] mg/d. Dextropropoxyphene and norpropoxyphene concentrations were 112 ± 38[45-199] and 65 ± 33[13-129] ng/mL, respectively. The intra-treatment QTc interval was >450 ms in only one patient (only with the Hodge correction). There were no cases of QTc > 500 ms, and there were no significant differences in the results considering different correction formulas (Bazzet, Fridericia, Framingham, Hodges). Dextropropoxyphene concentrations correlated with QTc (R > 0.45) interval and ΔQTc (R 0.52-0.87), whereas norpropoxyphene correlation was even greater for QTc (R > 0.40-0.64) and ΔQTc (R > 0.47-0.92). Depending on the QTc correction formula, eight patients presented ΔQTc > 30 ms and one patient with ΔQTc > 60 ms. No patient presented arrhythmia during the study. Conclusions: The authors did not observe a relationship between dextropropoxyphene and QTc interval prolongation at the therapeutic doses used in Argentina.
publishDate 2018
dc.date.none.fl_str_mv 2018-09
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
http://purl.org/coar/resource_type/c_6501
info:ar-repo/semantics/articulo
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/11336/177837
Keller, Guillermo Alberto; Villa Etchegoyen, Cecilia; Fernandez, Nicolas; Olivera, Nancy Monica; Quiroga, Patricia Noemí; et al.; Dextrophropoxyphene effects on QTc-interval prolongation: Frequency and characteristics in relation to plasma levels; Weston Medical Publishing; Journal of Opioid Management; 14; 5; 9-2018; 335-344
1551-7489
2375-0146
CONICET Digital
CONICET
url http://hdl.handle.net/11336/177837
identifier_str_mv Keller, Guillermo Alberto; Villa Etchegoyen, Cecilia; Fernandez, Nicolas; Olivera, Nancy Monica; Quiroga, Patricia Noemí; et al.; Dextrophropoxyphene effects on QTc-interval prolongation: Frequency and characteristics in relation to plasma levels; Weston Medical Publishing; Journal of Opioid Management; 14; 5; 9-2018; 335-344
1551-7489
2375-0146
CONICET Digital
CONICET
dc.language.none.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv info:eu-repo/semantics/altIdentifier/url/https://www.wmpllc.org/ojs/index.php/jom/article/view/2013
info:eu-repo/semantics/altIdentifier/doi/10.5055/jom.2018.0466
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
eu_rights_str_mv openAccess
rights_invalid_str_mv https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
dc.format.none.fl_str_mv application/pdf
application/pdf
application/pdf
application/pdf
dc.publisher.none.fl_str_mv Weston Medical Publishing
publisher.none.fl_str_mv Weston Medical Publishing
dc.source.none.fl_str_mv reponame:CONICET Digital (CONICET)
instname:Consejo Nacional de Investigaciones Científicas y Técnicas
reponame_str CONICET Digital (CONICET)
collection CONICET Digital (CONICET)
instname_str Consejo Nacional de Investigaciones Científicas y Técnicas
repository.name.fl_str_mv CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicas
repository.mail.fl_str_mv dasensio@conicet.gov.ar; lcarlino@conicet.gov.ar
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score 13.070432

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