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Table 2 Some drugs associated with QTc prolongation
- Antibiotics. azithromycin. clarithromycin. erythromycin. roxithromycin. metronidazole. (with alcohol) moxifloxan.
- Antifungals. fluconazole. (in cirrhosis) ketoconazole.
- Antivirals. nelfinavir.
- Antimalarials. chloroquine. mefloquine.
Video answer: Qt prolongation
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Drug–drug interactions also lead to QT prolongation. Quetiapine . Proposed — QT : Risperidone . Proposed — QT . Sudden death reported in PI. Ziprasidone Definite — QT Cancer chemotherapeutic agents Arsenic trioxide . Definite — QT, TdP : Tamoxifen . Probable — QT . Overdose situations. Cardiovascular non-anti-arrhythmics Indapamide . Proposed
Drugs that prolong the QT interval Drugs Category Antihistamines Anti-i nfectives Antineoplastics Anti arrhythmics Antilipemic agents Calcium channel blockers Diuretics Gastrointestinal agents Hormones Antidepressants Antipsychotic Astemizole, terfenadine Amantadine, clarithromycin, chloroquine, erythromycin, grepafloxacin, moxifloxacin, ...
QT prolonging drugs) Lofexidine (because of post-marketing reports of QT interval prolongation, some advise caution with other QT prolonging drugs) Olanzapine (studies suggest no effect but UK manufacturer advises caution on the basis that other antipsychotics have QT prolonging effects) Pentamidine (intravenous)
9. Haddad PM, Anderson IM. Anti-psychotic related QTc prolongation, torsades de pointes and sudden death. Drugs. 2002;62:1649-1671. 10. Taylor D. Ziprasidone in the management of schizophrenia: the QT interval issue in context. CNS Drugs. 2003:17:423-430. 11. Kupec IF. Seldane and generic terfenidine withdrawn from market. Feb 27, 1998.
Some of the more commonly encountered medicines known to prolong the QT interval are listed in table 1. These medicines are listed by CredibleMeds® as known to have a risk of torsades de pointes or are described as high risk in Stockley’s Drug interactions. Antimicrobials Antipsychotics Azithromycin Ciprofloxacin Clarithromycin Erythromycin
A long QT interval is most frequently seen with class I and class III antiarrhythmic drugs. Other classes of drugs that cause QT c prolongation include antihistamines, antidepressants, antibiotics, antifungal drugs and antipsychotics . The prolongation of the QT c interval by these drugs is usually seen within several days of starting them. The class Ia antiarrhythmic drugs (quinidine, procainamide) and class III drugs (sotalol, amiodarone) prolong the repolarisation phase of the cardiac ...
Some QT prolonging medications include amoxapine, ranolazine, and certain arrhythmia drugs. This part of the eMedTV library lists other drugs that may increase the risk of QT prolongation and describes the seriousness of the condition.
Few authors verified the utility of different drugs to prevent lengthening of QTc interval ...
Drug-induced QT prolongation. QT prolongation is a measure of delayed ventricular repolarisation, which means the heart muscle takes longer than normal to recharge between beats. It is an electrical disturbance which can be seen on an electrocardiogram (ECG). Excessive QT prolongation can trigger tachycardias such as torsades de pointes (TdP).
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