Clinical relevance and management of drug-related QT interval prolongation.
Much attention recently has focused on drugs that prolong the QT interval, potentially leading to fatal cardiac dysrhythmias (e.g., torsade de pointes). We provide a detailed review of the published evidence that supports or does not support an association between drugs and their risk of QT prolongation. The mechanism of drug-induced QT prolongation is reviewed briefly, followed by an extensive evaluation of drugs associated with QT prolongation, torsade de pointes, or both. Drugs associated with QT prolongation are identified as having definite, probable, or proposed associations. The role of the clinician in the prevention and management of QT prolongation, drug-drug interactions that may occur with agents known to affect the QT interval, and the impact of this adverse effect on the regulatory process are addressed.
Crouch
Michael A
MA
Department of Pharmacy, Virginia Commonwealth University, Medical College of Virginia, Richmond, Virginia 23298-0533, USA. macrouch@vcu.edu
Limon
Lynn
L
Cassano
Angela T
AT
D017277:Drug Approval / Q000331:legislation & jurisprudence; D004347:Drug Interactions; D064420:Drug-Related Side Effects and Adverse Reactions; D006801:Humans; D008133:Long QT Syndrome / Q000139:chemically induced*; D010819:Physician's Role; D016171:Torsades de Pointes / Q000139:chemically induced; D014481:United States; D014486:United States Food and Drug Administration