Dear Nancy, was this IV Domeridone, and were these doses comparable to
doses used in breastfeeding mothers taking oral Domperidone?
Thanks. Kathleen
SCARY ARTICLE SENT TO ME BY A BASIC SCIENTIST FRIEND:
Domperidone Should Not Be Considered a No-Risk Alternative to Cisapride
in
the Treatment of Gastrointestinal Motility Disorders
Benoit Drolet, MSc; Guy Rousseau, PhD; Pascal Daleau, PhD; Rene´
Cardinal,
PhD; Jacques Turgeon, PhD
Background—Several cases of QT prolongation and ventricular
tachyarrhythmia
have been reported with domperidone, a gastrokinetic and antiemetic
agent
available worldwide but still under investigation in the United States.
Although
electrolyte disturbances such as hypokalemia could account for some of
these
events, we hypothesized that domperidone
may have unsuspected electrophysiological effects predisposing some
patients
to proarrhythmia.
Methods and Results—Studies were undertaken in 9 isolated guinea pig
hearts,
which demonstrated reverse use–dependent prolongation of cardiac
repolarization by 100 nmol/L domperidone. Action potential duration
increased 27% from
baseline with domperidone (from 11463 to 14562 ms) during pacing at a
cycle length
of 250 ms, and a 9% increase (from 9762 to 10663 ms) was seen with
pacing at
a cycle length of 150 ms. Experiments in human ether-a-go-go–related
gene
(HERG)-transfected Chinese hamster ovary cells (n532) demonstrated a
concentration-dependent block of the rapid component (IKr) of the
delayed rectifier
potassium current. The tail current decreased by 50% at 162 nmol/L
domperidone.
Conclusions—Domperidone possesses cardiac electrophysiological effects
similar to those of cisapride and class III antiarrhythmic drugs. These
effects are
observed at clinically relevant concentrations of the drug. Therefore,
domperidone should not be
considered a no-risk alternative to cisapride, a drug that was recently
withdrawn from the US market. (Circulation. 2000;102:1883-1885.) Key
Words: arrhythmia n ion channels n torsade de pointes n
electrophysiology
n long-QT syndrome
ANYONE WHO WANTS THE FULL ARTICLE IN PDF, PLEASE EMAIL ME AND I WILL
ATTACH
IT.
Nancy
Nancy E. Wight MD, IBCLC, FAAP, FABM
Neonatologist
Children's Hospital and Sharp Mary Birch Hospital for Women Medical
Director, Sharp HealthCare Lactation Services San Diego, CA
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