Drug-induced arrhythmias.
The objective of this review is to characterize the mechanisms, risk factors, and offending pharmacotherapeutic agents that may cause drug-induced arrhythmias in critically ill patients. PubMed, other databases, and citation review were used to identify relevant published literature. The authors independently selected studies based on relevance to the topic. Numerous drugs have the potential to cause drug-induced arrhythmias. Drugs commonly administered to critically ill patients are capable of precipitating arrhythmias and include antiarrhythmics, antianginals, antiemetics, gastrointestinal stimulants, antibacterials, narcotics, antipsychotics, inotropes, digoxin, anesthetic agents, bronchodilators, and drugs that cause electrolyte imbalances and bradyarrhythmias. Drug-induced arrhythmias are insidious but prevalent. Critically ill patients frequently experience drug-induced arrhythmias; however, enhanced appreciation for this adverse event has the potential to improve prevention, treatment, patient safety, and outcomes in this patient population.
Barnes
Brian J
BJ
School of Pharmacy and Mid-America Thoracic and Cardiovascular Surgery, Inc., The University of Kansas Medical Center, Kansas City, KS, USA. bbarnes@kumc.edu
Hollands
James M
JM
D018685:Anesthetics, Inhalation / Q000009:adverse effects; D000889:Anti-Arrhythmia Agents / Q000009:adverse effects; D001145:Arrhythmias, Cardiac / Q000139:chemically induced* / Q000503:physiopathology / Q000517:prevention & control; D001919:Bradycardia / Q000139:chemically induced; D001993:Bronchodilator Agents / Q000009:adverse effects; D002316:Cardiotonic Agents / Q000009:adverse effects; D003422:Critical Care / Q000379:methods*; D004077:Digoxin / Q000009:adverse effects; D064420:Drug-Related Side Effects and Adverse Reactions / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D008133:Long QT Syndrome / Q000139:chemically induced / Q000503:physiopathology; D012307:Risk Factors; D016171:Torsades de Pointes / Q000139:chemically induced / Q000503:physiopathology; D014882:Water-Electrolyte Balance / Q000187:drug effects
D018685:Anesthetics, Inhalation; D000889:Anti-Arrhythmia Agents; D001993:Bronchodilator Agents; D002316:Cardiotonic Agents; D004077:Digoxin