Difference between revisions of "QT prolongation"

(Text replacement - "==Diagnosis==" to "==Evaluation==")
(Text replacement - "B-blocker" to "beta-blocker")
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*Unstable/sustained [[torsades]]--> [[defibrilation]] (unsynchronized)
 
*Unstable/sustained [[torsades]]--> [[defibrilation]] (unsynchronized)
 
*Stable
 
*Stable
**Slow HR ([[B-blockers]])
+
**Slow HR ([[beta-blockers]])
 
**May consider [[magnesium sulfate]]
 
**May consider [[magnesium sulfate]]
  

Revision as of 15:27, 1 August 2016

Background

Clinical Features

Differential Diagnosis

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

Evaluation

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

Management

Pause Dependent (precipitated by bradycardia)

Adrenergic Dependent (precipited by tachycardia)

Disposition

See Also

External Links

References