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The effect of metoclopramide on QT dynamicity: double‐blind, placebo‐controlled, cross‐over study in healthy male volunteers
Author(s) -
Elli̇dokuz E.,
Kaya D.
Publication year - 2003
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1046/j.1365-2036.2003.01641.x
Subject(s) - metoclopramide , medicine , supine position , placebo , anesthesia , qt interval , cisapride , cardiology , vomiting , alternative medicine , pathology
Summary Background : Metoclopramide, a central and peripheral dopamine type 2 receptor antagonist, has been used as an attractive and safer alternative to cisapride. However, cardiac side‐effects have also been reported with this drug. Aim : To evaluate the effects of intravenous metoclopramide administration on cardiac repolarization using QT dynamicity, a reliable indicator of arrhythmic side‐effects. Methods : The effect of metoclopramide on cardiac repolarization was evaluated in 10 healthy male volunteers in the supine position. Metoclopramide (10 mg) or placebo was administered intravenously at random in a double‐blind, cross‐over manner to the participants during continuous electrocardiographic recording in the supine position. The 30‐min stationary segments of the recordings before and after drug administration were used to investigate QT dynamicity. Results : Metoclopramide administration, but not placebo, resulted in steeper QT/RR slopes compared with the pre‐drug values (metoclopramide: 0.037 ± 0.004 vs. 0.064 ± 0.012; P = 0.041; placebo: 0.045 ± 0.006 vs. 0.050 ± 0.004; P = 0.563). In a two‐way analysis of variance model, metoclopramide administration also increased the QT variance independently ( F = 6.225, P = 0.023). Conclusions : Metoclopramide administration increases the QT/RR slope and QT variance. These findings may partly explain the underlying mechanism of ventricular arrhythmias associated with metoclopramide.