دورية أكاديمية
Management of prolonged QT interval and torsades de pointes in the intoxicated patient.
| العنوان: | Management of prolonged QT interval and torsades de pointes in the intoxicated patient. |
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| المؤلفون: | Kan AA; National Poisons Information Centre (NVIC), University Medical Centre Utrecht, Utrecht, the Netherlands., de Lange DW, Donker DW, Meulenbelt J |
| المصدر: | The Netherlands journal of medicine [Neth J Med] 2014 Apr; Vol. 72 (3), pp. 119-26. |
| نوع المنشور: | Journal Article; Review |
| اللغة: | English |
| بيانات الدورية: | Publisher: Van Zuiden Communications Country of Publication: Netherlands NLM ID: 0356133 Publication Model: Print Cited Medium: Internet ISSN: 1872-9061 (Electronic) Linking ISSN: 03002977 NLM ISO Abbreviation: Neth J Med Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2002- : Alphen aan de Rijn, The Netherlands : Van Zuiden Communications Original Publication: Haarlem, Bohn |
| مواضيع طبية MeSH: | Drug Overdose/*physiopathology , Drug Overdose/*therapy , Torsades de Pointes/*physiopathology , Torsades de Pointes/*therapy, Drug Overdose/complications ; Electrocardiography ; Heart Rate ; Humans ; Risk Assessment ; Risk Factors ; Torsades de Pointes/chemically induced |
| مستخلص: | Many drugs can significantly influence cardiac repolarisation causing an increased duration of this repolarisation phase, challenging the repolarisation reserve. This may set the stage for life-threatening ventricular arrhythmias such as torsades de pointes (TdP). TdP generally occurs in conjunction with a prolonged QT interval (QT) on the electrocardiogram. The Dutch Poisons Information Centre (NVIC) often receives information requests about drugs that can influence the QT already at therapeutic dosages. Drug-induced QT prolongation is dose dependent and hence can be particularly pronounced in overdose situations. Also, additional risk factors for the development of life-threatening arrhythmias are often present in intoxicated patients. This review focuses on identification and management of drug-intoxicated patients who are at risk for a reduction in their repolarisation reserve, measured by their QT interval. The QT interval is strongly dependent on heart rate, which has led to the introduction of different methods to adjust the QT interval, i.e. the QTc. Bazett's formula, which has been used for decades, lacks accuracy concerning QTc calculation at higher and lower heart rates, situations often relevant when dealing with intoxicated patients. Additionally, we highlight drugs with QT-prolonging potential that are commonly associated with an overdose setting in the Netherlands. Finally, standard treatment options specifically pointed toward the intoxicated patient at risk of QT prolongation and TdP will be discussed. |
| التعليقات: | Comment in: Neth J Med. 2014 Jul;72(6):340. (PMID: 25319864) |
| تواريخ الأحداث: | Date Created: 20140522 Date Completed: 20150831 Latest Revision: 20140521 |
| رمز التحديث: | 20221213 |
| PMID: | 24846924 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 1872-9061 |
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