Interactions médicamenteuses et risque de torsades de pointes
Bibliographic record
Abstract
Resume: Objectif : Certaines etudes pharmacoepidemiologiques font etat de plus de 10 000 morts annuellement au Canada a la suite de l’utilisation inappropriee de medicaments. De plus, on denote par des etudes semblables qu’environ 30 % des hospitalisations seraient reliees a des problemes de pharmacotherapie. Resume du cas : Une patiente traitee par de la quinidine, de la risperidone et de l’indapamide se voit prescrire de la clarithromycine pour une sinusite aigue. Le risque d’interactions medicamenteuses graves est-il present et quelles en seraient les consequences? Discussion : Des modifications dans le metabolisme ou le transport des medicaments presents au dossier pharmacologique de cette patiente risquent de provoquer un allongement important de l’intervalle QT. De plus, ces interactions medicamenteuses peuvent induire une potentialisation des effets electrophysiologiques cardiaques de certains de ces medicaments. Les mecanismes sous-jacents a ces interactions seront discutes, ce qui menera a la conclusion que l’administration de clarithromycine peut creer une condition predisposant a des risques de torsades de pointes et de mort subite. Abstract Objective : Numerous pharmacoepidemiological studies have established that, in Canada, 10,000 patient deaths can be attributed to inappropriate use of medication. Similar studies have also shown that approximately 30% of patient hospitalizations are associated to drug related problems. Case Summary : A patient currently treated with quinidine, risperidone and indapamide has been prescribed clarithromycin for treatment of acute sinusitis. What is the risk of clinically significant drug interactions and their consequences? Discussion : Alterations in the metabolism or transport of medications already present in the pharmacological history of this patient can increase the risk of a prolonged QT interval. In addition, there may be increased electrophysiological effects of medications on the heart. Possible mechanisms of action will be discussed, concluding with the proposition that, as a result of drug interactions, clarithromycin use can increase the risk of torsades de pointes and sudden death. Key Words : Cytochrome P450, drug interactions, torsades de pointes, ABC transporters, potassium channels.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.008 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.008 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".