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Updated: Sep 29, 2026

Methods for ECG Evaluation of Indicators of Cardiac Risk, and Susceptibility to Aconitine-induced Arrhythmias in Rats Following Status Epilepticus
Published on: April 5, 2011
[Risk of drug interactions. Combinations of drugs associated with ventricular arrhythmias]
José Luis Viramontes-Madrid1, Carlos Jerjes-Sánchez, Ingris Pelaez-Ballestas
1Servicio de Urgencias, Hospital de Enfermedades Cardiovasculares y del Tórax, Centro Médico del Norte, Instituto Mexicano del Seguro Social, Monterrey, NL. jose_viramontes@merck.com
Objective:
To determine the frequency of concurrent use of cisapride, astemizole and terfenadine with macrolides and azole antimitotics, drug combinations that have been reported in the literature as producing a pharmacological interaction associated with potentially fatal ventricular arrhythmias.
Material And Methods:
A retrospective analysis of a total of 72,444 prescriptions generated by 611 physicians during a 6 months period for ambulatory patients, was performed. The database included a register of automatic alerts produced every time a predetermined drug combination was detected.
Results:
145 potentially risk situations were detected, with an incidence rate to 2.1 cases per 1,000 prescriptions, which increases to 6.2% when prescriptions for terfenadine, astemizole, and cisapride were included, with 12, 9 y 5%, respectively. Only 36 physicians (6%) wrote prescriptions producing alerts, and about half (45%) were pediatricians. The same physician prescribed both drugs in 31% of the cases.
Conclusion:
The use of drug combinations associated with a high risk of potentially fatal ventricular arrhythmias is relatively high in Mexico. An electronic online detecting system showed to be useful in preventing this kind of potential pharmacological interactions.
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