Torsades de pointes: Difference between revisions
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==Treatment== | ==Treatment== | ||
# | #Magnesium | ||
#Overdrive pacing | ##1-2gm IV over 1-2 min; then 1-2gm/hr gtt | ||
#Isoproterenol | #Overdrive pacing | ||
##Goal HR 90-120 | |||
#Isoproterenol | |||
##2-8 mcg/min | |||
==See Also== | ==See Also== | ||
Revision as of 22:15, 27 February 2012
Background
Drugs that inhibit P450
- erythromycin
- biaxin
- ketoconozole
- itraconozole
- certain antihistamines like terfandadine or astemizole, inhibit the delayed rectifier potassium channel
- terfenadine is completely metabolized in liver. Once metabolized, has no cardiac activity
- unmetabolized terfenadine has quinidine- like activity- gives torsades
- if P450 enz inhibited by other drug, then will have increase in concentration of unmetabolized terfanadine.
Treatment
- Magnesium
- 1-2gm IV over 1-2 min; then 1-2gm/hr gtt
- Overdrive pacing
- Goal HR 90-120
- Isoproterenol
- 2-8 mcg/min
See Also
Source
10/07 DONALDSON (adapted from Tintinalli, Lampe)
