Drug-Induced QT Interval Prolongation: Mechanisms, Risk Factors, Genetics and Clinical Management

2019 ◽  
Author(s):  
Gözde Aktürk ◽  
Şule Kalkan
Keyword(s):  
Risk Factors ◽  
Clinical Management ◽  
Qt Interval ◽  
Interval Prolongation ◽  
Drug Induced ◽  
Qt Interval Prolongation

Clinical characteristics of patients with drug-induced QT interval prolongation and torsade de pointes: identification of risk factors

2008 ◽  
Vol 98 (4) ◽  
pp. 208-212 ◽  
Author(s):  
Konstantinos P. Letsas ◽  
Michalis Efremidis ◽  
Stavros P. Kounas ◽  
Loukas K. Pappas ◽  
Gerasimos Gavrielatos ◽  
...  
Keyword(s):  
Risk Factors ◽  
Qt Interval ◽  
Clinical Characteristics ◽  
Torsade De Pointes ◽  
Interval Prolongation ◽  
Drug Induced ◽  
Qt Interval Prolongation

scholarly journals Drug-induced QT interval prolongation: mechanisms and clinical management

2012 ◽  
Vol 3 (5) ◽  
pp. 241-253 ◽  
Author(s):  
Senthil Nachimuthu ◽  
Manish D. Assar ◽  
Jeffrey M. Schussler
Keyword(s):  
Clinical Management ◽  
Qt Interval ◽  
Interval Prolongation ◽  
Drug Induced ◽  
Qt Interval Prolongation

SSRIs and QT interval prolongation management. A review

2017 ◽  
Vol 41 (S1) ◽  
pp. S750-S750
Author(s):  
A. Ballesteros ◽  
H. Saiz ◽  
Á.S. Rosero ◽  
A. Portilla ◽  
L. Montes ◽  
...  
Keyword(s):  
Risk Factors ◽  
Qt Interval ◽  
Future Research ◽  
Current Debate ◽  
Qtc Interval ◽  
Interval Prolongation ◽  
Drug Induced ◽  
Cross Sectional ◽  
Qt Interval Prolongation ◽  
Qtc Interval Prolongation

IntroductionIn 2011, the FDA issued an alert recommending not to prescribe citalopram high doses, due to QT prolongation risk. We explored the clinical background of QT interval prolongation related to serotonin selective reuptake inhibitors (SSRI) use and the clinical implications of safety issues.MethodologyA review was conducted to clarify the mechanisms associated with the occurrence of TdP when using SSRI and investigating therapeutic measures to avoid/minimize these effects. The literature search was conducted in PubMed data reviewing articles between 2001 and 2016.Results(1) Related to risk factors/intraclass differences: risk factors are increase in QTc interval ≥60 ms from the pretreatment value, advanced age, female sex, acute myocardial infarction and electrolytic abnormalities among others. Citalopram appears more likely than others to induce this phenomenon but its importance is under current debate. (2) Related to dose: drug-induced QTc interval prolongation and TdP was associated to citalopram in doses > 40 mg/day. However, psychotropic drug-induced sudden cardiac death may be an outlier in the absence of identified risk factors for QTc interval prolongation and TdP. (3) Related to poly-pharmacy/management: there is an additive effect when using SSRI and antipsychotics (EKG control is recommended in those cases). Cross-sectional studies showed that SSRI use was not associated with QT interval prolongation. This could be explained by the EKG intra-intersubject variability.ConclusionsThere is little evidence that drug-associated QTc interval prolongation by itself is sufficient to predict TdP. Future research needs to improve its precision to better understand the factors that facilitate/attenuate that progression. Clarifying this may lead to a safer SSRI use.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Drug-induced QT interval prolongation in cancer patients

2011 ◽  
Vol 4 (4) ◽  
pp. 223
Author(s):  
Torben K. Becker ◽  
Sai-Ching J. Yeung
Keyword(s):  
Cancer Patients ◽  
Qt Interval ◽  
Alkylating Agents ◽  
Torsade De Pointes ◽  
Interval Prolongation ◽  
Drug Induced ◽  
Vascular Disruption ◽  
Qt Interval Prolongation ◽  
Increased Risk ◽  
Multiple Drugs

Cancer patients are at an increased risk for QT interval prolongation and subsequent potentially fatal Torsade de pointes tachycardia due to the multiple drugs used for treatment of malignancies and the associated symptoms and complications. Based on a systematic review of the literature, this article analyzes the risk for prolongation of the QT interval with antineoplastic agents and commonly used concomitant drugs. This includes anthracyclines, fluorouracil, alkylating agents, and new molecularly targeted therapeutics, such as vascular disruption agents. Medications used in the supportive care can also prolong QT intervals, such as methadone, 5-HT3-antagonists and antihistamines, some antibiotics, antifungals, and antivirals. We describe the presumed mechanism of QT interval prolongation, drug-specific considerations, as well as important clinical interactions. Multiple risk factors and drug–drug interactions increase this risk for dangerous arrhythmias. We propose a systematic approach to evaluate cancer patients for the risk of QT interval prolongation and how to prevent adverse effects.

Modelling of drug-induced QT-interval prolongation: estimation approaches and translational opportunities

2015 ◽  
Vol 42 (6) ◽  
pp. 659-679 ◽  
Author(s):  
Eleonora Marostica ◽  
Karel Van Ammel ◽  
Ard Teisman ◽  
Koen Boussery ◽  
Jan Van Bocxlaer ◽  
...  
Keyword(s):  
Qt Interval ◽  
Interval Prolongation ◽  
Drug Induced ◽  
Qt Interval Prolongation

332 – Risk factors of qt interval prolongation in 1000 patients with schizophrenia

2008 ◽  
Vol 98 ◽  
pp. 170
Author(s):  
Y. Ozeki ◽  
K. Fujii ◽  
N. Kurimoto ◽  
K. Tsuji ◽  
N. Yamada ◽  
...  
Keyword(s):  
Risk Factors ◽  
Qt Interval ◽  
Interval Prolongation ◽  
Qt Interval Prolongation
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