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Отдельные группы лекарственных средств, прием которых ассоциирован с развитием лекарственно-индуцированной фибрилляции предсердий

https://doi.org/10.33667/2078-5631-2021-11-20-28

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Аннотация

Последнее время все больше внимания уделяется проблеме лекарственно‑индуцированной (ЛИ) фибрилляции предсердий (ФП). Известно, что развитие ЛИ ФП может быть ассоциировано с приемом сердечно‑сосудистых и противоопухолевых лекарственных средств (ЛС), ЛС, влияющих на центральную нервную систему или органы дыхания. Однако имеются и другие ЛС, которые могут провоцировать ЛИ ФП, о чем практикующие врачи осведомлены в гораздо меньшей степени. Данная статья представляет собой обзор современной литературы о ЛИ ФП, ассоциированной с приемом других групп ЛС и отдельных препаратов, не вошедших в вышеперечисленные группы. Анализ имеющейся литературы показал, что частота развития ЛИ ФП достигает 6,9% при приеме золедроновой кислоты и 1,5% – при приеме алендроната, хотя данные разных авторов в отношении причинно‑следственной связи между терапией бисфосфонатами и развитием ФП неоднозначны. Использование высоких доз глюкокортикостероидов (в суточной дозе ≥ 7,5 мг в пересчете на преднизолон) также ассоциировано с повышенным риском развития ФП (ОШ = 6,07; 95% ДИ: 3,90–9,42). Лечение нестероидными противовоспалительными средствами также взаимосвязано с более высоким риском развития ЛИ ФП по сравнению с лицами, не принимающими таковые,– коэффициент заболеваемости 1,17 (95% ДИ: 1,10–1,24) для неселективных и 1,27 (95% ДИ: 1,20–1,34) для ингибиторов циклооксигеназы‑2. В литературе имеются описание клинических случаев возникновения ЛИ ФП на фоне приема иммунодепрессантов (азатиоприн, метотрексат + этанерцепт, финголимод, циклоспорин); ЛС, влияющих на мочеполовую систему (варденафил, силденафил, йохимбина гидрохлорид, гексопреналин); местного анестетика бупивакаина, анаболических стероидов (тестостерона энантат, станозолол, ципионат тестостерон, нандролона деканоат, экстраболин) и никотин‑содержащего средства (никотин‑содержащая жевательная резинка).

Об авторах

О. Д. Остроумова
ФГБОУ ДПО «Российская медицинская академия непрерывного последипломного образования» Минздрава России
Россия

Остроумова Ольга Дмитриевна, д.м.н., проф., зав. кафедрой терапии и полиморбидной патологии

Москва



М. С. Черняева
ФГБУ ДПО «Центральная государственная медицинская академия» Управления делами Президента Российской Федерации; ГБУЗ «Госпиталь для ветеранов войн № 2 Департамента здравоохранения Москвы»
Россия

Черняева Марина Сергеевна, к.м.н., доцент кафедры внутренних болезней и профилактической медицины; врач‑терапевт

eLibrary SPIN: 2244–0320 

Москва



Д. И. Бахтеева
ГБУЗ «Госпиталь для ветеранов войн № 2 Департамента здравоохранения Москвы»
Россия

Бахтеева Дамира Исхаковна, врач‑терапевт

Москва



Н. А. Араблинский
ФГАОУ ВО «Российский национальный исследовательский медицинский университет имени Н. И. Пирогова» Минздрава России
Россия

Араблинский Никита Александрович, студент VI курса

Москва



Д. А. Сычев
ФГБОУ ДПО «Российская медицинская академия непрерывного последипломного образования» Минздрава России
Россия

Сычев Дмитрий Алексеевич, д.м.н., проф., чл.‑корр. РАН, зав. кафедрой клинической фармакологии и терапии, ректор

Москва



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Остроумова О.Д., Черняева М.С., Бахтеева Д.И., Араблинский Н.А., Сычев Д.А. Отдельные группы лекарственных средств, прием которых ассоциирован с развитием лекарственно-индуцированной фибрилляции предсердий. Медицинский алфавит. 2021;1(11):20-28. https://doi.org/10.33667/2078-5631-2021-11-20-28

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Ostroumova O.D., Cherniaeva M.S., Bakhteeva D.I., Arablinskiy N.A., Sychyov D.A. Some groups of drugs which use is associated with development of drug-induced atrial fibrillation. Medical alphabet. 2021;1(11):20-28. (In Russ.) https://doi.org/10.33667/2078-5631-2021-11-20-28

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ISSN 2078-5631 (Print)