Dergi Ara >>
Yıl:2007; Cilt: 20; Sayı: 2>> Özet
TAM METİN
Düşünen Adam: Psikiyatri ve Nörolojik Bilimler Dergisi; 2007;20(2):97-108
Antipsikotikler, QT aralığı ve Torsades de Pointes
E Kurt, B Akman, G Alataş, T Oral
Bakırköy Ruh ve Sinir Hastalıkları Hastanesi, İstanbul
Oniki derivasyonlu EKG'deki en uzun ve en kısa QT aralığı arasındaki farka QT dispersiyonu (QTd) denir. Artmış QTd, ventriküler repolarizasyonun ileri derecede artmış değişkenliğinin göstergesidir; aritmi için gerçek bir risktir ve ani ölüme neden olabilir. QTc uzamasını ve Torsades de Pointes'i (TdP) indükleyen kazanılmış nedenler arasında en büyük grubu ilaçlar oluşturur. Kardiyak repolarizasyonu uzatan ilaçlar, olası ölümcül aritmiler (TdP) oluşturabilir. Ilaç kullanımıyla gelişen anlamlı QTc uzaması riski genellikle doza bağımlıdır ve ilac kesilince geri dönüşlüdür. QTc aralığının uzaması, antipsikotik ilacın sınıfına, dozuna ve ilaç etkilesimlerine de bağlıdır. Bununla birlikte antipsikotik ilaçların geleneksel dozlarda uzun süre kullanılmasının hem QTc değerini hem de QT dispersiyonunu uzattığını gösteren çalışmalar da vardır. Bu yazıda antipsikotiklerin QT süresi ve dispersiyonuna etkisi incelenmiştir.
Antipsychotic medications, QT interval and Torsades de Pointes
QT interval dispersion is the distance between maximum QT and minimum QT intervals on surface 12 lead ECG. Im eased QT dispersion is associated with serious cardiac rhythm disturbances and sudden cardiac death. The largest group of acquired reasons of prolongation of QTc and TdP is drugs. The drugs which prolong cardiac repolarization can cause probable fatal arrhythmias (TdP). Generally remarkable prolongation of QTc due to drug use is dependent to dosage and is revased when it is stopped. Prolongation of QTc also depends on the class and dosage of antipsychotic drug and the drug interactions. However there are also other studies showing use of antipsychotic drugs at conventional dosages for a long period of time, prolongs both QTc and QT dispersion (QTd). In this paper we have evaluated the effects of antipsychotic drugs on QTc and QT dispersion.

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