Document Detail


Cardiac effects of sodium stibogluconate: myocardial, electrophysiological and biochemical studies.
MedLine Citation:
PMID:  7922300     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The pentavalent antimonial sodium stibogluconate is the mainstay of anti-leishmanial therapy. Sodium stibogluconate is less cardiotoxic than antimony and the trivalent derivatives, but has been associated with dose-related electrocardiographic changes. The effect of the currently-used regimen of sodium stibogluconate (20 mg/kg/day for 20 days) on cardiac function is uncertain. We studied 12 soldiers, mean age 24 years, with proven cutaneous leishmaniasis treated with this regimen. There were no significant changes in echocardiographic indices of left ventricular systolic or diastolic function during treatment. Indices of myocardial electrical stability (heart-rate variability and episodes of overt supraventricular and ventricular arrhythmias) were unchanged, but there was a reversible decrease in T-wave amplitude during treatment. Systolic and diastolic blood pressure fell and the heart rate increased during treatment. This regimen of sodium stibogluconate does not measurably impair left ventricular systolic or diastolic function. Minor T-wave changes occur during treatment, but there is no increase in arrhythmia frequency or change in heart-rate variability. In most young fit patients, this regimen has no cardiac side-effects. However, idiosyncratic reactions cannot be excluded, and patients with malnutrition, impaired renal function or pre-existing heart disease may be more sensitive to any cardiotoxic properties of sodium stibogluconate.
Authors:
N C Hepburn; J Nolan; L Fenn; R M Herd; J M Neilson; G R Sutherland; K A Fox
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  QJM : monthly journal of the Association of Physicians     Volume:  87     ISSN:  1460-2725     ISO Abbreviation:  QJM     Publication Date:  1994 Aug 
Date Detail:
Created Date:  1994-11-10     Completed Date:  1994-11-10     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9438285     Medline TA:  QJM     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  465-72     Citation Subset:  IM    
Affiliation:
Department of Dermatology, Royal Infirmary, Edinburgh, UK.
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MeSH Terms
Descriptor/Qualifier:
Adult
Antimony Sodium Gluconate / adverse effects,  therapeutic use*
Blood Pressure / drug effects
Creatine Kinase / metabolism
Electrocardiography
Humans
L-Lactate Dehydrogenase / metabolism
Leishmaniasis, Cutaneous / drug therapy*,  enzymology
Male
Military Personnel
Myocardium / enzymology
Prospective Studies
Ventricular Function, Left / drug effects*
Chemical
Reg. No./Substance:
0/Antimony Sodium Gluconate; EC 1.1.1.27/L-Lactate Dehydrogenase; EC 2.7.3.2/Creatine Kinase

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