Difference between revisions of "QT prolongation"

(Text replacement - "Category:Tox" to "Category:Toxicology")
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***Antihistamines
 
***Antihistamines
 
**[[Electrolyte Abnormalities]] ([[hypoKalemia]], [[hypoMag]], [[hypoCa]])
 
**[[Electrolyte Abnormalities]] ([[hypoKalemia]], [[hypoMag]], [[hypoCa]])
 +
***Hypokalemia triad
 +
****Long QT, ST depressions, PVCs<ref>Matt A. Mattu ECG Case: May 20 2012. uemergencymed. May 21, 2012. https://www.youtube.com/watch?v=T-wqZfRmKQ4.</ref>
 
**Diet related (starvation, low protein)
 
**Diet related (starvation, low protein)
 
**[[Severe Bradycardia]]/AV Block
 
**[[Severe Bradycardia]]/AV Block

Revision as of 21:44, 26 March 2016

Diagnosis

  • QTc >440 (male), >460 (female)
  • >500 = real concern (may result in torsades)

Differential Diagnosis

  • Pause Dependent (Aquired)
  • Adrenergic Dependent
    • Congenital
      • Jarvel/Lange-Nielsen
        • (+deafness; AR)
      • Romano-Ward synd
        • (nl hearing; AD)
      • Sporatic
      • Mitral valve prolapse
    • Acquired
      • CVA (subarachnoid)
      • Autonomic surg (catechol excess: neck dissection, carotid endarterect, truncal vagotomy)

Drug List

  • Antiarrhythmics
    • Amiodarone, disopyramide, dofetilide, flecainide, ibutilide, mexiletine, procainamide, quinidine, sotalol
  • Antibiotics
    • Macrolide
      • Azithromycin, erythromycin, clarithromycin
    • Fluoroquinolone
      • Ciprofloxacin, gatifloxacin, gemifloxacin, levofloxacin, moxifloxacin, ofloxacin
    • Other
      • Pentamidine, telithromycin, trimethoprim-sulfamethoxazole
  • Antidepressants
    • Amitriptyline, citalopram, doxepin, fluoxetine, nortriptyline, paroxetine, sertraline, venlafaxine
  • Antiemetics
    • Dolasetron, droperidol, granisetron, ondansetron
  • Antifungals
    • Fluconazole, itraconazole, ketoconazole, voriconazole
  • Antihypertensives
    • Nicardipine
  • Antineoplastics
    • Lapatinib, nilotinib, sunitinib, tamoxifen
  • Antimalarials
    • Chloroquine, halofantrine
  • Antipsychotics
    • Chlorpromazine, clozapine, galantamine, haloperidol, lithium, paliperidone, pimozide, quetiapine, risperidone, thioridazine, ziprasidone
  • Antivirals
    • Amantadine, atazanavir, foscarnet
  • Diuretics
    • Indapamide
  • Immune suppressants
    • Tacrolimus
  • Opiates
    • Methadone
  • Phosphodiesterase inhibitors
    • Sildenafil, vardenafil
  • Skeletal muscle relaxants
    • Tizanidine
  • Urinary antispasmodics
    • Solifenacin

Treatment

Pause Dependent (precipitated by bradycard)

Adrenergic Dependent (precipited by tachycardia)

See Also

External Links

References

  1. Matt A. Mattu ECG Case: May 20 2012. uemergencymed. May 21, 2012. https://www.youtube.com/watch?v=T-wqZfRmKQ4.