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Chloroquine cardiac effects and toxicity.A short update.
Int J Antimicrob Agents. 2020 Jun 18;:106057
Authors: Mubagwa K
Abstract
There is currently an increased interest in using the antimalarials chloroquine and hydroxychloroquine for the treatment of other diseases, including cancer and viral infections such as COVID-19. However, risks of cardiotoxic effects tend to limit their use. The effects of these drugs on the electrical and mechanical activities of the heart, as well as on the remodeling of the cardiac tissue are presented, and the underlying molecular and cellular mechanisms discussed. The drugs can have proarrhythmic as well as antiarrhythmic actions, resulting from their inhibition of ion channels, including voltage-dependent Na+ and Ca2+ channels, background and voltage-dependent K+ channels, and pacemaker channels. The drugs also exert a vagolytic effect, due at least in part to a muscarinic receptor antagonist action. They also interfere with the normal autophagy flux, an effect which could aggravate ischemia/reperfusion injury or post-infarct remodeling. Most of the toxic effects occur at high concentrations, following prolonged drug administration or in the context of drug associations.
PMID: 32565195 [PubMed - as supplied by publisher]