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Emergency department approach to QTc prolongation. [Review]

MedStar author(s):

Citation: American Journal of Emergency Medicine. 35(12):1928-1933, 2017 DecPMID: 28855066Institution: MedStar Washington Hospital CenterDepartment: Emergency MedicineForm of publication: Journal ArticleMedline article type(s): Journal Article | ReviewSubject headings: *Anti-Bacterial Agents/ae [Adverse Effects] | *Antiemetics/ae [Adverse Effects] | *Antipsychotic Agents/ae [Adverse Effects] | *Emergency Service, Hospital | *Long QT Syndrome/di [Diagnosis] | *Torsades de Pointes/di [Diagnosis] | Drug Overdose/co [Complications] | Drug Overdose/pp [Physiopathology] | Electrocardiography | Guideline Adherence | Humans | Long QT Syndrome/ci [Chemically Induced] | Practice Patterns, Physicians' | Risk Factors | Torsades de Pointes/ci [Chemically Induced] | United States/ep [Epidemiology]Year: 2017 Local holdings: Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006ISSN:

0735-6757

Name of journal: The American journal of emergency medicineAbstract: QTc prolongation has been associated with increased risk of developing ventricular tachydysrhythmias, particularly Torsades de Pointes (TdP). QTc prolongation is influenced by many factors including congenital causes, heart rate, metabolic imbalances, and pharmacotherapy. Several commonly used medications in the emergency department (ED), such as antipsychotics and antiemetics, are known to prolong the QT interval. In addition, ED patients may present with conditions that may predispose them to QTc prolongation, such as drug overdose or hypokalemia, which can further complicate management. ED providers should not only be aware of which medications have these effects, but must also thoroughly investigate any pertinent patient history that may contribute to QTc prolongation. This review discusses commonly encountered medications that are associated with QTc prolongation, the mechanisms by which they prolong the QTc interval, and other factors that may influence ED medication administration and management. Copyright (c) 2017 Elsevier Inc. All rights reserved.All authors: Almulhim M, Chistov S, Mazer-Amirshahi M, Pourmand A, Sabha Y, Vukomanovic DFiscal year: FY2018Digital Object Identifier:

https://dx.doi.org/10.1016/j.ajem.2017.08.044

Date added to catalog: 2017-09-18

Holdings ( 1 )
Title notes ( 3 )

Holdings
Item type	Current library	Collection	Call number	Status	Date due	Barcode
Journal Article	MedStar Authors Catalog	Article	28855066	Available		28855066

Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006

QTc prolongation has been associated with increased risk of developing ventricular tachydysrhythmias, particularly Torsades de Pointes (TdP). QTc prolongation is influenced by many factors including congenital causes, heart rate, metabolic imbalances, and pharmacotherapy. Several commonly used medications in the emergency department (ED), such as antipsychotics and antiemetics, are known to prolong the QT interval. In addition, ED patients may present with conditions that may predispose them to QTc prolongation, such as drug overdose or hypokalemia, which can further complicate management. ED providers should not only be aware of which medications have these effects, but must also thoroughly investigate any pertinent patient history that may contribute to QTc prolongation. This review discusses commonly encountered medications that are associated with QTc prolongation, the mechanisms by which they prolong the QTc interval, and other factors that may influence ED medication administration and management. Copyright (c) 2017 Elsevier Inc. All rights reserved.

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