Torsades de pointes causes: Difference between revisions
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Revision as of 02:21, 15 October 2012
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Causes
Long QT syndrome can either be inherited as congenital mutations of ion channels carrying the cardiac impulse/action potential or acquired as a result of drugs that block these cardiac ion currents.
Common causes for torsades de pointes include hypomagnesemia and hypokalemia. It is commonly seen in malnourished individuals and chronic alcoholics. Drug interactions such as erythromycin or Avelox, taken concomitantly with inhibitors like nitroimidazole, Diarrhea, dietary supplements, and various medications like methadone, Lithium, tricyclic antidepressants or phenothiazines may also contribute.
The List of Drugs that Cause Torsades de pointes
Drugs that are generally accepted to have a risk of causing torsades de pointes:
- Amiodarone
- Arsenic trioxide
- Astemizole
- Azithromycin
- Bepridil
- Chloroquine
- Chlorpromazine
- Cisapride
- Citalopram
- Clarithromycin
- Disopyramide
- Dofetilide
- Domperidone
- Droperidol
- Erythromycin
- Halofantrine
- Haloperidol
- Ibutilide
- Levomethadyl
- Mesoridazine
- Methadone
- Moxifloxacin
- Pentamidine
- Pimozide
- Probucol
- Procainamide
- Quinidine
- Sevoflurane
- Sotalol
- Sparfloxacin
- Terfenadine
- Thioridazine
- Vandetanib
Drugs that Possibly Cause Torsades de pointes
Drugs that in some reports have been associated with torsades de pointes and/or QT prolongation but at this time lack substantial evidence for causing torsades de pointes.
- Alfuzosin
- Amantadine
- Artenimol and piperaquine
- Atazanavir
- Azithromycin
- Chloral hydrate
- Clozapine
- Dolasetron
- Dronedarone
- Eribulin
- Escitalopram
- Famotidine
- Felbamate
- Fingolimod
- Flecainide
- Foscarnet
- Fosphenytoin
- Gatifloxacin
- Gemifloxacin
- Granisetron
- Iloperidone
- Indapamide
- Isradipine
- Lapatanib
- Levofloxacin
- Lithium
- Mirtazipine
- Moexipril / HCTZ
- Moxifloxacin
- Nicardipine
- Nilotinib
- Octreotide
- Ofloxacin
- Ondansetron
- Oxytocin
- Paliperidone
- Perflutren
- Quetiapine
- Ranolazine
- Risperidone
- Roxithromycin
- Sertindole
- Sunitinib
- Tacrolimus
- Tamoxifen
- Telithromycin
- Tizanidine
- Vardenafil
- Venlafaxine
- Voriconazole
- Ziprasidone
The List of Drugs that Cause Torsades de pointes in Certain Conditions
Drugs that, in some reports, have been weakly associated with torsades de pointes and/or QT prolongation but that are unlikely to be a risk for torsades de pointes when used in usual recommended dosages and in patients without other risk factors (e.g., concomitant QT prolonging drugs, bradycardia, electrolyte disturbances, congenital long QT syndrome, concomitant drugs that inhibit metabolism)
- Amitriptyline
- Amoxapine
- Ciprofloxacin
- Citalopram
- Clomipramine
- Desipramine
- Doxepin
- Fluconazole
- Fluoxetine
- Galantamine
- Imipramine
- Itraconazole
- Ketoconazole
- Mexiletine
- Nortriptyline
- Paroxetine
- Protriptyline
- Sertraline
- Solifenacin
- Trimethoprim-Sulfamethoxazole
- Trimipramine