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Introduction: The Bradford Hill criteria are a widely used, useful tool for the assessment of biomedical causation. We have examined their application to pharmacovigilance using the example of cisapride-induced QTc interval prolongation/arrhythmia.

Methods: A literature search was conducted using MEDLINE, EMBASE, Reactions Weekly and regulatory websites to identify evidence for the association between cisapride and QTc interval prolongation/arrhythmia that had been published in the English language.

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Age-dependent effects on cisapride-induced QTc prolongation in the isolated guinea pig heart.

J Pharmacol Toxicol Methods

October 2006

Procter and Gamble Pharmaceuticals, Miami Valley Innovation Center, 11810 E. Miami River Rd. Cincinnati, OH 45252, USA.

Introduction: The isolated guinea pig heart preparation has been suggested as a suitable small animal model for investigating potential for QTc prolongation. The purpose of this study was to investigate the effect of age on electrophysiological parameters measured in the isolated guinea pig heart preparation. In addition, the effect of a compound known to prolong the QT interval (cisapride) was investigated in both young and adult guinea pigs.

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Background: Cisapride is a possible cause of potentially life threatening QT prolongation.

Aims: We investigated these cardiac side effects in premature infants, mainly in relation to fetal growth.

Patients: Forty six preterms (mean birth weight 1.

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Background: Cisapride, a gastrointestinal prokinetic agent, was recently withdrawn from the market because of its propensity to induce torsade de pointes (TdP) arrhythmias. The present study examines the electrophysiological actions of cisapride in the isolated arterially perfused canine left ventricular wedge preparation.

Methods And Results: Transmembrane action potentials from epicardial and M regions and a pseudo-ECG were simultaneously recorded.

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[Cisapride and risk of cardiac complications].

Minerva Pediatr

June 2000

Clinica Pediatrica R, P. O. Aiuto Materno, Palermo.

Cisapride is a prokinetic agent thought to be without severe side effects. Recently, rare cisapride-induced cardiotoxic effects (QT interval prolongation, ventricular arrhythmias) have been reported, raising questions about its safety. Some risk factors have been reported: overdosage of cisapride, association with some drugs inhibiting hepatic metabolism via the cytochrome P450 3A4 enzymatic system (such as azole antifungals, macrolide antibiotics, non sedating antihistamines), other pharmacological agents increasing the parasympathetic tone by raising the effect of cisapride (such as ranitidine and cimetidine), electrolyte abnormalities (such as low serum levels of calcium, potassium and magnesium in the blood), liver dysfunctions, congenital long QT syndrome, and infants born before 36 weeks' gestation, for three months after birth.

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