Drug-induced q-T prolongation.
Drug therapy may induce Q-T prolongation by alteration of potassium ion currents in cardiac cells, resulting in abnormal repolarization. Q-T prolongation, whether congenital or acquired, has been associated with the development of the malignant dysrhythmia Torsade de Pointes (TdP), which may result in sudden death. Re-cent regulatory actions and drug withdrawals due to Q-T prolongation or TdP have focused attention on this issue. Although our understanding of the pathophysiology continues to evolve, both patient and medication factors contribute to the individual risk of drug-induced Q-T prolongation or TdP. The clinician should be aware of these issues when prescribing new drugs and should weigh the risks and benefits carefully when prescribing drugs known to prolong the Q-T interval.
Kao
Louise W
LW
Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN 46206, USA. lkao@clarian.org
Furbee
R Brent
RB
D000889:Anti-Arrhythmia Agents / Q000009:adverse effects; D000900:Anti-Bacterial Agents / Q000009:adverse effects; D044966:Anti-Retroviral Agents / Q000009:adverse effects; D002121:Calcium Channel Blockers / Q000009:adverse effects; D016757:Death, Sudden, Cardiac / Q000209:etiology / Q000517:prevention & control; D004347:Drug Interactions; D064420:Drug-Related Side Effects and Adverse Reactions; D006634:Histamine H1 Antagonists / Q000009:adverse effects; D006801:Humans; D008133:Long QT Syndrome / Q000139:chemically induced* / Q000517:prevention & control; D011041:Poisoning / Q000503:physiopathology / Q000517:prevention & control; D011619:Psychotropic Drugs / Q000009:adverse effects; D016171:Torsades de Pointes / Q000139:chemically induced* / Q000517:prevention & control
D000889:Anti-Arrhythmia Agents; D000900:Anti-Bacterial Agents; D044966:Anti-Retroviral Agents; D002121:Calcium Channel Blockers; D006634:Histamine H1 Antagonists; D011619:Psychotropic Drugs