Potassium current antagonist properties and proarrhythmic consequences of quinolone antibiotics

Mark E. Anderson, Alexander Mazur, Tao Yang, Dan M. Roden

Research output: Contribution to journalArticle

Abstract

Quinolones are clinically important antibiotic drugs. One quinolone antibiotic, sparfloxacin (SPX), has been recently reported to increase the QT interval, and another quinolone, grepafloxacin (GRX), was withdrawn because it induced torsade de pointes (TdP), a polymorphic ventricular tachycardia (VT) linked to excessive QT interval prolongation. To determine whether SPX, GRX, and other recently developed quinolones, gatifloxacin (GAT) and moxifloxacin (MOX), have similar, potentially deleterious, properties we compared these agents in two ways. First, we measured their relative antagonist potency against the rapid component of the delayed rectifier K+ current (IKr), and second we determined the QT interval prolongation and inducibility of VT and TdP using a well established in vivo rabbit arrhythmia model. All of these agents are IKr antagonists with the following IC50 values (mean ± S.E.) for IKr block: SPX, 0.23 ± 0.07 μM; MOX, 0.75 ± 0.31 μM; GAT, 26.5 ± 13.4 μM; and GRX, 27.2 ± 11.6 μM. All agents also increased the maximum QT interval (mean ± S.E.) from baseline (241 ± 10 ms): SPX, 370 ± 30 ms; MOX, 270 ± 30 ms; GRX, 280 ± 25 ms; and GAT, 255 ± 23 ms. No agents caused TdP during a standard 30-min observation period, but SPX-treated animals developed nonsustained VT (three of six) and TdP (one of six) during an extended 60-min observation period. These findings show that IKr block may be a common feature of many quinolone antibiotics, and that the proarrhythmic consequences vary according to IKr antagonist potency, but are also influenced by additional, unidentified factors.

Original languageEnglish (US)
Pages (from-to)806-810
Number of pages5
JournalJournal of Pharmacology and Experimental Therapeutics
Volume296
Issue number3
StatePublished - Mar 14 2001
Externally publishedYes

ASJC Scopus subject areas

  • Molecular Medicine
  • Pharmacology

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