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Detrimental haemodynamic effects of cyclizine in heart failure
L B Tan1, S Bryant, R G Murray
1Cardiac Department, John Radcliffe Hospital, Oxford.
Insights
Intravenous cyclizine, an antiemetic, was studied in severe heart failure patients. It increased blood pressure and filling pressures, suggesting it should be avoided in heart failure cases.
Area of Science:
- Cardiology
- Pharmacology
- Critical Care Medicine
Background:
- Cyclizine is an antiemetic commonly administered with opioids.
- Its use is noted in patients with left ventricular failure and myocardial infarction.
- Hemodynamic effects in severe heart failure are not well understood.
Purpose of the Study:
- To investigate the hemodynamic effects of intravenous cyclizine.
- To assess its impact on patients with severe heart failure.
Main Methods:
- Studied 11 patients diagnosed with severe heart failure.
- Administered intravenous cyclizine and monitored hemodynamic parameters.
Main Results:
- Cyclizine significantly elevated systemic and pulmonary arterial pressures.
- It also increased right and left ventricular filling pressures.
- The drug counteracted the venodilatory effects of diamorphine.
Conclusions:
- Intravenous cyclizine adversely affects hemodynamics in severe heart failure.
- Its use in heart failure patients is strongly discouraged.
- Clinicians should avoid cyclizine in this patient population.
Abstract:
The haemodynamic effects of intravenous cyclizine, an antiemetic that is widely given with opioids in left ventricular failure and myocardial infarction, were studied in 11 patients with severe heart failure. Cyclizine significantly increased systemic and pulmonary arterial pressures, and right and left ventricular filling pressures, and negated the venodilatory effects of diamorphine. The use of cyclizine in patients with heart failure should, therefore, be avoided.