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QT prolonging medication

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https://www.readbyqxmd.com/read/29349356/qt-interval-prolongation-due-to-medication-found-in-the-preoperative-evaluation
#1
Mika Seto, Sayo Koga, Ryosuke Kita, Toshihiro Kikuta
QT prolongation is an electrocardiographic change that can lead to lethal arrhythmia. Acquired QT prolongation is known to be caused by drugs and electrolyte abnormalities. We report three cases in which the prolonged QT interval was improved at the time of operation by briefly discontinuing the drugs suspected to have caused the QT prolongation observed on preoperative electrocardiography. The QTc of cases 1, 2, and 3 improved from 518 to 429 ms, 463 to 441 ms, and 473 to 443 ms on discontinuing the use of a gastrointestinal prokinetic agent, a proton pump inhibitor, and a molecular targeted drug, respectively...
December 2017: Journal of Dental Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29317399/effect-of-a-single-dose-of-i-v-ondansetron-on-qtc-interval-in-emergency-department-patients
#2
Kai Li, Kathy Vo, Byron K Lee, Newton Addo, Zlatan Coralic
PURPOSE: Results of a study to determine whether i.v. administration of a single dose of 4 mg of ondansetron was associated with QT interval prolongation in emergency department (ED) patients are reported. METHODS: In a prospective observational study conducted at an urban academic medical center ED, a convenience sample of adult ED patients treated with ondansetron 4 mg i.v. were enrolled. A 12-lead electrocardiogram (ECG) was obtained immediately before and 5 minutes after ondansetron administration...
January 9, 2018: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/29298624/approach-to-initiating-qt-prolonging-oncology-drugs-in-the-ambulatory-setting
#3
Mário L de Lemos, Carrie Kung, Victoria Kletas, Nadine Badry, Isabell Kang
Since the introduction of regulatory drug approval guidance on the evaluation of QT interval prolongation, an increasing number of drug monographs has included cautions on the risk of QT prolongation. For example, QT prolongation is mentioned in the Canadian product monographs of 29 drugs commonly seen in oncology practice. This presents two major challenges. First, most guidelines and risk predictive tools for QT prolongation have been developed for hospitalized patients in acute care settings. In contrast, most QT-prolonging oncology drugs are used in medically stable patients in the ambulatory setting...
January 1, 2018: Journal of Oncology Pharmacy Practice
https://www.readbyqxmd.com/read/29275963/qt-prolongation-torsades-de-pointes-and-psychotropic-medications-a-5-year-update
#4
REVIEW
Scott R Beach, Christopher M Celano, Alan M Sugrue, Caitlin Adams, Michael J Ackerman, Peter A Noseworthy, Jeff C Huffman
BACKGROUND: Some psychotropic medications have been associated with prolongation of the QT interval and QT prolongation, especially in those with medical illness, and are linked to lethal ventricular arrhythmias, such as Torsades de Pointes (TdP). In 2013, we published a review of QT prolongation, TdP, and psychotropic medications. OBJECTIVE: We provide an update over the past 5 years on the specific concerns most relevant to clinicians who see medically ill patients...
November 3, 2017: Psychosomatics
https://www.readbyqxmd.com/read/29259513/torsades-de-pointes-after-ondansetron-infusion-in-2-patients
#5
Danny Y Lee, Tri Trinh, Sion K Roy
Drugs that prolong the electrocardiographic QT interval increase the risk of ventricular arrhythmias, particularly torsades de pointes. Ondansetron, a 5-hydroxytryptamine type 3 receptor antagonist antiemetic, is one such drug. We present the cases of 2 patients who were given intravenous ondansetron and subsequently developed torsades de pointes. Both had normal QT intervals at baseline but were discovered to have risk factors that predisposed them to drug-induced QT prolongation and ventricular arrhythmias...
October 2017: Texas Heart Institute Journal
https://www.readbyqxmd.com/read/29258620/refractory-ventricular-fibrillations-after-surgical-repair-of-atrial-septal-defects-in-a-patient-with-cacna1c-gene-mutation-case-report
#6
Ai Kojima, Fumiaki Shikata, Toru Okamura, Takashi Higaki, Seiko Ohno, Minoru Horie, Shunji Uchita, Yujiro Kawanishi, Kenji Namiguchi, Takumi Yasugi, Hironori Izutani
BACKGROUND: Congenital long QT syndrome (LQTS) can cause ventricular arrhythmic events with syncope and sudden death resulting from malignant torsades de pointes (TdP) followed by ventricular fibrillations (VFs). However, the syndrome is often overlooked prior to the development of arrhythmic events in patients with congenital heart diseases demonstrating right bundle branch block on electrocardiogram (ECG). We present a case of an adult patient with congenital heart disease who developed VFs postoperatively, potentially due to his mutation in a LQTS related gene, which was not identified on preoperative assessment due to incomplete evaluation of his family history...
December 19, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29247520/lithium-induced-electrocardiographic-changes-a-complete-review
#7
REVIEW
Nikhil Mehta, Robert Vannozzi
Lithium has been used for the treatment of bipolar disorder for more than 6 decades. Reports of cardiac side effects resulting in both benign electrocardiographic (ECG) changes and near fatal arrhythmias have been reported in the literature. A systematic literature search was conducted on 2 electronic databases-PubMed and Medline-for the time period between January 1970 and March 2016 using the key word "lithium," along with "electrocardiography" or "ECG." All articles and their references were then screened by title for relevance by 2 authors and a librarian...
December 16, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/29234678/follow-up-measurement-of-corrected-qt-interval-in-adult-patients-before-and-after-lung-transplantation
#8
Dirk Bandorski, Reinhard Hoeltgen, Nicole Becker, Winfried Padberg, Harilaos Bogossian, Christoph Wiedenroth, Matthias Arlt, Christian Hamm, Werner Seeger, Hossein Ardeschir Ghofrani, Matthias Hecker, Henning Gall, Konstantin Mayer
Background: Prolongation of the corrected QT (QTc) interval is well known for many drugs, some of which are an integral part of the therapeutic regimen after lung transplantation (LTX). Therefore, we investigated the QTc interval after LTX in the present study. Patients and Methods: The medical records of patients after LTX were studied for demographic data, indication of LTX, medication, and baseline and follow-up ECGs. The QT interval was corrected for the patient's heart rate using the different formulae of Bazett, Fridericia, Hodges, and Framingham...
2017: BioMed Research International
https://www.readbyqxmd.com/read/29224509/algorithms-used-to-identify-ventricular-arrhythmias-and-sudden-cardiac-death-in-retrospective-studies-a-systematic-literature-review
#9
Yizhou Ye, E Paul Larrat, Aisling R Caffrey
Drug-induced QT interval prolongation may increase the risk of sudden cardiac death or ventricular arrhythmias (SCD/VA), and therefore affects the safety profile of medications. Administrative databases can be used to inform pharmacoepidemiologic drug safety studies for such rare events. In order to compare event rates between studies, validated operational definitions of these events are needed. We conducted a systematic literature review in PubMed to identify algorithms for SCD/VA. Twenty-two studies were included in the review...
December 1, 2017: Therapeutic Advances in Cardiovascular Disease
https://www.readbyqxmd.com/read/29218680/cardiovascular-profile-of-valbenazine-analysis-of-pooled-data-from-three-randomized-double-blind-placebo-controlled-trials
#10
Dao Thai-Cuarto, Christopher F O'Brien, Roland Jimenez, Grace S Liang, Joshua Burke
INTRODUCTION: Valbenazine is a novel vesicular monoamine transporter 2 inhibitor approved for the treatment of tardive dyskinesia in adults. OBJECTIVE: Using data from double-blind, placebo-controlled trials, analyses were conducted to evaluate the cardiovascular effects of once-daily valbenazine in patients with a psychiatric disorder who developed tardive dyskinesia after exposure to a dopamine-blocking medication. METHODS: Data were pooled from three 6-week, double-blind, placebo-controlled trials: KINECT (NCT01688037), KINECT 2 (NCT01733121), and KINECT 3 (NCT02274558)...
December 7, 2017: Drug Safety: An International Journal of Medical Toxicology and Drug Experience
https://www.readbyqxmd.com/read/29191244/frequency-characteristics-and-risk-factors-of-qt-interval-prolonging-drugs-and-drug-drug-interactions-in-cancer-patients-a-multicenter-study
#11
Qasim Khan, Mohammad Ismail, Sehrash Khan
BACKGROUND: Cancer patients may receive a high number of medications with the potential to prolong QT interval and subsequent TdP (torsades de pointes). This study aimed to identify the prevalence of QT prolonging drugs, their TdP risk, QT prolonging drug-drug interactions (QT-DDIs), levels, predictors, and TdP risk of drugs involved in QT-DDIs. METHODS: This multicenter study included cancer patients from three major tertiary care hospitals of Khyber-Pakhtunkhwa, Pakistan...
December 1, 2017: BMC Pharmacology & Toxicology
https://www.readbyqxmd.com/read/29185542/pimavanserin-a-novel-therapeutic-option-for-parkinson-disease-psychosis
#12
REVIEW
Trevor Hawkins, Brian D Berman
Purpose of review: In April 2016, the Food and Drug Administration (FDA) approved a first-in-class atypical antipsychotic medication called pimavanserin for the treatment of Parkinson disease psychosis (PDP). We aim to inform readers about its indications, effectiveness, and safety profile. Recent findings: Pimavanserin acts as an inverse agonist at serotonin 5-HT2A receptors and has negligible effects on other receptors, thereby avoiding the D2 receptor antagonism that can potentially worsen motor symptoms...
April 2017: Neurology. Clinical Practice
https://www.readbyqxmd.com/read/29173600/a-practical-approach-to-avoiding-cardiovascular-adverse-effects-of-psychoactive-medications
#13
REVIEW
Judith Brouillette, Stanley Nattel
Drugs that act on mental state, generally termed "psychoactive agents," are among the most widely used medications in medicine. Psychoactive agents can affect the cardiovascular system and must be used carefully to avoid negative cardiovascular consequences. In the present article we review the potential adverse cardiovascular consequences of psychoactive medications and provide suggestions for practical approaches to avoiding them. We consider adverse reactions in terms of: (1) arrhythmias (particularly acquired long QT syndrome); (2) blood pressure; (3) ventricular function; (4) effect on risk factors; (5) teratogenicity; and (6) drug interactions...
December 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/29160150/electrocardiogram-screening-in-children-with-congenital-sensorineural-hearing-loss-prevalence-and-follow-up-of-abnormalities
#14
Zainab Farzal, Jonathan Walsh, Faisal I Ahmad, Jason Roberts, Sunita J Ferns, And Carlton J Zdanski
Objective The purpose is to determine the prevalence of electrocardiogram (ECG) abnormalities, including borderline and prolonged QT, among screened children with sensorineural hearing loss (SNHL) and to analyze their subsequent medical workup. Study Design Institutional Review Board-approved case series with chart review. Setting Tertiary academic center. Subjects and Methods Cases from 1996 to 2014 involving pediatric patients (N = 1994) with SNHL were analyzed. Abnormal ECGs were categorized as borderline/prolonged QT or other...
November 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/29139041/drug-safety-analysis-in-a-real-life-cohort-of-parkinson-s-disease-patients-with-polypharmacy
#15
Saskia Müller-Rebstein, Claudia Trenkwalder, Jens Ebentheuer, Wolfgang H Oertel, Carsten Culmsee, Günter U Höglinger
BACKGROUND: Polypharmacy is common in geriatric Parkinson's disease (PD) patients in advanced disease stages with multiple comorbidities, bearing multiple risks for drug safety in theory. OBJECTIVE: The aim of this study was to empirically identify the most frequent and relevant contraindications and drug interactions actually occurring and compromising drug safety in PD in real life. METHODS: We conducted a prospective observational study in a multimorbid cohort of PD patients with polypharmacy admitted to a specialized hospital...
November 14, 2017: CNS Drugs
https://www.readbyqxmd.com/read/29121487/risk-of-cardiac-events-in-long-qt-syndrome-patients-when-taking-antiseizure-medications
#16
David S Auerbach, Yitschak Biton, Bronislava Polonsky, Scott McNitt, Robert A Gross, Robert T Dirksen, Arthur J Moss
Many antiseizure medications (ASMs) affect ion channel function. We investigated whether ASMs alter the risk of cardiac events in patients with corrected QT (QTc) prolongation. The study included people from the Rochester-based Long QT syndrome (LQTS) Registry with baseline QTc prolongation and history of ASM therapy (n = 296). Using multivariate Anderson-Gill models, we assessed the risk of recurrent cardiac events associated with ASM therapy. We stratified by LQTS genotype and predominant mechanism of ASM action (Na(+) channel blocker and gamma-aminobutyric acid modifier...
October 20, 2017: Translational Research: the Journal of Laboratory and Clinical Medicine
https://www.readbyqxmd.com/read/29103053/domperidone-for-hypotension-in-parkinson-s-disease-a-systematic-review
#17
Stephen Bacchi, Ivana Chim, Philippe Kramer, Ronald B Postuma
BACKGROUND: Domperidone is a proposed treatment of orthostatic hypotension (OH) in Parkinson's disease (PD). However, domperidone use in PD is tempered by concerns regarding QT prolongation and ventricular tachyarrhythmia and sudden cardiac death (VT/SCD). OBJECTIVE: The aim is to identify peer-reviewed studies in which either (1) the effect of domperidone on blood pressure in patients with PD, or (2) the adverse effects associated with domperidone use in PD patients has been reported...
2017: Journal of Parkinson's Disease
https://www.readbyqxmd.com/read/29092657/the-impact-of-cirrhosis-and-prescription-medications-on-qtc-interval-before-and-after-liver-transplantation
#18
Andrew D Santeusanio, Kevin G Dunsky, Stephanie Pan, Thomas D Schiano
BACKGROUND: Higher rates of corrected QT (QTc) prolongation have been reported in patients with cirrhosis. The impact of liver transplantation and prescription medications on the natural history of QTc prolongation has yet to be well characterized. METHODS: This was a single-center review of patients receiving (group 1) or listed for (group 2) a liver transplant during 2014. Patients in group 1 were followed prospectively from the date of transplantation to assess rates of QTc normalization posttransplant...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/29066038/assessing-responsiveness-of-health-systems-to-drug-safety-warnings
#19
Lauren B Gerlach, Hyungjin Myra Kim, Matheos Yosef, Anne E Sales, Claire Stano, Helen C Kales, Kara Zivin
OBJECTIVE: In 2011-2012 the U.S. Food and Drug Administration (FDA) issued safety announcements cautioning providers against prescribing high doses of citalopram given concerns for QT prolongation. The authors evaluated Veterans Affairs (VA) national trends in citalopram use and dose compared with alternative antidepressants after the FDA warnings. METHODS: Time series analyses estimated the effect of the FDA warnings on citalopram and other antidepressant across three periods: before the first FDA warning in August 2011, after the 2011 FDA warning until the second warning in March 2012, and after the 2012 FDA warning...
September 28, 2017: American Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/29057193/long-qt-syndrome-unveiled-by-a-fatal-combination-of-medications-and-electrolyte-abnormalities
#20
Pooja Sethi, Jennifer Treece, Vandana Pai, Chidinma Onweni
Long QT syndrome (LQTS) can present with syncope and seizure-like activity in the setting of torsades de pointes (TdP) with hemodynamic instability. Electrolyte abnormalities and medications can predispose to TdP in the setting of latent LQTS. An implantable cardioverter defibrillator (ICD) is needed if patients with TdP continue to be symptomatic despite medical treatment. We report a case of a patient who presented with seizures and was found to have prolonged corrected QT interval (QTc). During her admission, she was treated with ondansetron...
August 18, 2017: Curēus
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