Tavşanlarda damar içi oksitosin ve metil ergonovin enjeksiyonunun QT süresi üzerine etkileri
Bu araştırma ile tavşanlara oksitosin (OKS) ve metil ergonovinin (ME) yalnız başlarına veya birlikte enjeksiyonları sonrası kalp atım sayısı (KA), QT ve QTc değerlerindeki değişimlerin araştırılması amaçlanmıştır. Bu amaçla her bir grupta 6 tavşan olacak şekilde 9 grup oluşturulmuş ve enjeksiyonlar yapılmıştır [1. grup (0.5 U OKS/tavşan), 2. grup (1 U OKS/tavşan), 3. grup (3 U OKS/tavşan), 4. grup (0.1 mg ME/tavşan), 5. grup (0.2 mg ME/tavşan), 6. grup (0.3 mg ME/tavşan), 7. grup (0.5 U OKS + 0.1 mg ME/tavşan), 8. grup (1 U OKS + 0.2 mg ME/tavşan) ve 9. grup (3 U OKS + 0.3 mg ME/tavşan)]. Enjeksiyon öncesi ve enjeksiyon sonrası 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 12, 14, 16, 18 ve 20. dakikalarda EKG kayıtları alınmıştır. Elektrokardiyogram kayıtlarından KA, QT ve QTc değerleri hesaplanmıştır. Oksitosinin yalnız başına veya ME ile birlikte uygulandığı gruplarda enjeksiyon sonrası KA değerleri istatistiksel olarak anlamlı şekilde azalmıştır (P
The effects of intravenous oxytocin and methylergonovine administration on QT interval in rabbits
The aim of this study was to evaluate changes in heart rate (HR), QT, and QTc values in conscious female New Zeland rabbits which intravenously received oxytocin (OXT), methylergonovine (ME) and OXT plus ME at different dosages. Animals were divided in to 9 equal groups; Group 1 (n=6, received 0.5 U OXT per animal), group 2 (n=6, received 1 U OXT per animal), group 3 (n=6, received 3 U OXT per animal), group 4 (n=6, 0.1 mg ME per animal), group 5 (n=6, received 0.2 mg ME per animal), group 6 (n=6, received 0.3 mg ME per animal), group 7 (n=6, received 0.5 U OXT + 0.1 mg ME per animal), group 8 (n=6, received 1 U OXT + 0.2 mg ME per animal) and group 9 (n=6, received 3 U OXT + 0.3 mg ME per animal). Electrocardiographical recording were taken from all animals before injection and then at 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 12, 14, 16, 18 and 20. minutes of each drug administration. The HR, QT and QTc values were estimated from ECG recording. The HR values decreased in OXT and OXT plus ME injected groups (P<0.001). In these groups prolongation of QT and QTc intervals were observed after drug injection during the 1-3 minutes (P<0.001). There were not determined significant changes of all observed parameters in ME injected groups. In conclusion, it should be taken into consideration by the physicians QT prolongation and short-term and serious bradycardia due to OXT application. The results of the study also suggest that ME may be safer than OXT in terms of HR and QT intervals.
___
- 1. Dildy GA: Postpartum hemorrhage: New management option. Clin Obstet Gynecol, 45 (2): 330-344, 2002.
- 2. Arnold CE, Payne M, Thompson JA, Slovis NM, Bain FT: Periparturient hemorrhage in mares: 73 cases (1998-2005). J Am Vet Med Assoc, 232 (9): 1345-1351, 2008.
- 3. Smith FO: Postpartum diseases. Vet Clin North Am: Small Anim Pract, 16 (3): 521-524, 1986.
- 4. De Groot AN, van Dongen PW, Vree TB, Hekster YA, van Roosmalen J: Ergot alkaloids. Current status and review of clinical pharmacology and therapeutic use compared with other oxytocics in obstetrics and gynaecology. Drugs, 56 (4): 523-535, 1998.
- 5. Yap YG, Camm AJ: Drug induced QT prolongation and torsades de pointes. Heart, 89 (11): 1363-1372, 2003.
- 6. Why Mothers Die 1997-1999. Confidental enquiries into maternal deaths in United Kingdom. London, RCOG Pres. URL: http://www.cemach.org.uk.
- 7. Charbit B, Funck-Brentano C, SamaBn E, Jannier-Guillou V, Albaladejo P, Marty J: QT interval prolongation after oxytocin bolus during surgical induced abortion. Clin Pharmacol Ther, 76 (4): 359-364, 2004.
- 8. Uzun M, Yapar K, Uzlu E, Çitil H, Erdoğan HM: QT interval prolongation and decreased heart rates after intravenous bolus oxytocin injection in male and female conscious rabbits. Gen Physiol Biophys, 26 (3): 168-172, 2007.
- 9. Leung SW, Ng PS, Wong WY, Cheung TH: A randomised trial of carbetocin versus syntometrine in the management of the third stage of labour, BJOG, 113 (12): 1459-1464, 2006.
- 10. Fridericia LS: Die Systolendauer im Elektrokardiogramm bei normalen Menschen und bei Herzkranken. Acta Med Scand, 53, 469-80, 1920.
- 11. Mousa HA, Walkinshaw S: Major postpartum haemorrhage. Curr Opin Obstet Gynecol, 13 (6): 595-603, 2001.
- 12. Mukaddam-Daher S, Yin YL, Roy J, Gutkowska J, Cardinal R: Negative inotropic and chronotropic effects of oxytocin. Hypertension, 38 (2): 292-296, 2001.
- 13. Gutkowska J, Jankowski M, Lambert C, Mukaddam- Daher S, Zingg HH, McCann SM: Oxytocin releases atrial natriuretic peptide by combining with oxytocin receptors in the heart. Proc Nat Acad Sci USA, 94 (21): 11704-11709, 1997.
- 14. Tsui BC, Stewart B, Fitzmaurice A, Williams R: Cardiac arrest and myocardial infarction induced by postpartum intravenous ergonovine administration, Anesthesiology, 94, 363-364, 2001.
- 15. Ibrahim SM, Mustafa E, Louon A: Postpartum severe sinus bradycardia following methlyergonovine administration. J Int Med Res, 36 (5): 1129-1133, 2008.
- 16. Meenagh C, Mulholland C, Ryan MF: Magnesium homeostasis and antipsychotic-induced QTc prolongation. J Psychopharmacol, 18 (3): 438-439, 2004.