Diuretic-induced ventricular ectopic activity

Holland, O. B.; Nixon, J.V.; Kuhnert, La Von

doi:10.1016/0002-9343(81)90530-1

Cited by 347 publications

(55 citation statements)

References 29 publications

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“…Some of these patients may already have a low serum potassium as a result of treatment with corticosteroids or because they are receiving diuretics and digoxin for co-existent heart failure. Hypokalaemia has been associated with cardiac arrhythmias (Cole et al, 1981;Holland et al, 1981;Thomas, 1983 We (Smith & Kendall, 1985), and others (Holgate et al, 1980;Harvey et al, 1981) have previously shown that tolerance occurs to some of the unwanted responses to ,-adrenoceptor stimulants after long-term use, although the hypokalaemic response persists to some degree (Smith & Kendall, 1985). It is possible that the effects of such tolerance are offset by the combination of theophylline with the 32-adrenoceptor stimulant.…”

Section: Discussionmentioning

confidence: 99%

Potentiation of the adverse effects of intravenous terbutaline by oral theophylline.

Smith¹,

Kendall²

1986

Brit J Clinical Pharma

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We have studied the influence of therapeutic plasma concentrations of theophylline on some of the unwanted responses to intravenous terbutaline in normal subjects. There was a significantly greater fall in serum potassium and rise in plasma glucose, pulse rate and systolic blood pressure in response to an intravenous infusion of terbutaline when theophylline was present compared with when terbutaline was given alone. These drugs are commonly used together in the treatment of acute asthma and potentiation of side effects may be hazardous. We suggest monitoring of the serum potassium when these drugs are used together during acute exacerbations of asthma.

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Section: Discussionmentioning

confidence: 99%

Potentiation of the adverse effects of intravenous terbutaline by oral theophylline.

Smith¹,

Kendall²

1986

Brit J Clinical Pharma

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“…The former is common and has been shown to be associated with increased ventricular ectopic activity (Holland, Nixon and Kuhnert, 1981). However, it is not known whether the incidence of serious arrhythmias is increased, although some authors have speculated that this is so.…”

Section: Discussionmentioning

confidence: 99%

Ventricular fibrillation and initial plasma potassium in acute myocardial infarction

Thomas

1983

Postgraduate Medical Journal

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SummaryIn a retrospective review of patients admitted to a coronary care unit, 809 patients had a definite myocardial infarction and plasma potassium was measured within 48 hr. The mean (± s.d.) plasma potassium was 4.04 (± 0.56) mmol/litre. A potassium concentration of less than 4.0 mmol/litre was found in 383 patients, of whom 14 had ventricular fibrillation. A potassium concentration of 4.0 mmol/litre or greater was found in 426 patients, of whom 3 had ventricular fibrillation, a difference significant at the 0.4% level (X2 test). Preceding diuretic therapy did not appear to be relevant and there appeared to be no other difference between the two groups. The maintenance of a high-normal plasma potassium, or the prevention of its reduction, in patients with an acute myocardial infarction may be important.

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“…During the period when most of the sudden deaths occurred, the predominant treatment available consisted of diuretics and reserpine. Other studies have shown an association of diuretic therapy with ventricular arrhythmias and in persons with prior CHD, with sudden death (56)(57)(58). It is not clear whether hypokalemia is responsible for these associations.…”

Section: Cardiac Failurementioning

confidence: 99%

Framingham Study Insights into Hypertensive Risk of Cardiovascular Disease.

1995

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Elevated blood pressure is a common and powerful predisposing factor for stroke, coronary disease, cardiac failure and peripheral artery disease imposing a 2-3 fold increased risk of one or more of these atherosclerotic sequelae. The risk ratio imposed by hypertension is greatest for cardiac failure and stroke, but in Western countries coronary disease is the most common and lethal hazard. In hypertensive men and women respectively, 35% and 45% of myocardial infarctions are silent or unrecognized necessitating routine periodic ECG examination for its detection. Comparison of the impacts of systolic and diastolic blood pressure gives no indication of a greater impact of diastolic pressure and isolated systolic hypertension is distinctly hazardous. Over-reliance on diastolic pressure to assess risk can be misleading, particularly in advanced age. Attributable risk estimates suggest that 78% of hypertension in men and 65% in women is directly attributable to adiposity, making weight control of paramount importance for primary prevention of hypertension. The likelihood of development of cardiovascular disease in the hypertensive patient is greatly enhanced by the presence of metabolically-linked risk factors and already existent cardiovascular conditions. These influence the urgency and choice of therapy. Rational and efficient assessment of the hypertensive candidate for cardiovascular disease requires use of a cardiovascular risk profile evaluating the joint effect of multiple risk factors and effective treatment improves multivariate risk. (Hypertens Res 1995; 18: 181-196)

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Diuretic-induced ventricular ectopic activity

Cited by 347 publications

References 29 publications

Potentiation of the adverse effects of intravenous terbutaline by oral theophylline.

Potentiation of the adverse effects of intravenous terbutaline by oral theophylline.

Ventricular fibrillation and initial plasma potassium in acute myocardial infarction

Framingham Study Insights into Hypertensive Risk of Cardiovascular Disease.

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