[QTc-prolonging drugs and the risk of sudden death].
Various drugs can be associated with QT prolongation. A prolonged QT interval leads to an increased risk for the development of ventricular tachyarrhythmias, particularly polymorphic ventricular tachycardia (torsades de pointes). Polymorphic arrhythmia may rapidly develop into ventricular fibrillation and cause sudden death. Torsades de pointes is classically associated with early depolarization. This review article discusses the mechanisms of QTc prolongation and triggering factors for proarrhythmia, drugs that prolong QT interval (class III antiarrhythmic agents, antimicrobial agents - fluoroquinolone and macrolide antibiotics, antipsychotic and antidepressant drugs, agents used in general anesthesia, antimycotics, and several other drugs), nonpharmacological and pharmacological risk factors for arrhythmias (due to pharmacokinetic-pharmacodynamic interactions), the treatment and recommendations to prevent arrhythmia related to QT prolongation.
Reingardiene
Dagmara
D
Department of Intensive Therapy, Kaunas University of Medicine, Kaunas, Lithuania. minjan@sonex.lt
Vilcinskaite
Jolita
J
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000777:Anesthetics / Q000009:adverse effects; D000889:Anti-Arrhythmia Agents / Q000009:adverse effects; D000900:Anti-Bacterial Agents / Q000009:adverse effects; D000928:Antidepressive Agents / Q000009:adverse effects; D000935:Antifungal Agents / Q000009:adverse effects; D014150:Antipsychotic Agents / Q000009:adverse effects; D001145:Arrhythmias, Cardiac / Q000139:chemically induced / Q000517:prevention & control; D016757:Death, Sudden, Cardiac / Q000209:etiology*; D004347:Drug Interactions; D064420:Drug-Related Side Effects and Adverse Reactions; D004562:Electrocardiography; D005260:Female; D024841:Fluoroquinolones / Q000009:adverse effects; D006801:Humans; D008133:Long QT Syndrome / Q000139:chemically induced*; D018942:Macrolides / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012737:Sex Factors; D017180:Tachycardia, Ventricular / Q000139:chemically induced*; D016171:Torsades de Pointes / Q000139:chemically induced*; D014693:Ventricular Fibrillation / Q000139:chemically induced
D000777:Anesthetics; D000889:Anti-Arrhythmia Agents; D000900:Anti-Bacterial Agents; D000928:Antidepressive Agents; D000935:Antifungal Agents; D014150:Antipsychotic Agents; D024841:Fluoroquinolones; D018942:Macrolides