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Drugs Causing Torsades de Pointes

Torsades de Pointes (TdP) is a polymorphic ventricular tachycardia linked to prolonged QT intervals, often caused by various drug classes including antiarrhythmics, antibiotics, antifungals, antipsychotics, antidepressants, and antiemetics. Risk factors for drug-induced TdP include electrolyte imbalances, bradycardia, congenital Long QT Syndrome, and the use of multiple QT-prolonging medications. Close monitoring of QT intervals and electrolyte correction are essential for prevention.

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13 views3 pages

Drugs Causing Torsades de Pointes

Torsades de Pointes (TdP) is a polymorphic ventricular tachycardia linked to prolonged QT intervals, often caused by various drug classes including antiarrhythmics, antibiotics, antifungals, antipsychotics, antidepressants, and antiemetics. Risk factors for drug-induced TdP include electrolyte imbalances, bradycardia, congenital Long QT Syndrome, and the use of multiple QT-prolonging medications. Close monitoring of QT intervals and electrolyte correction are essential for prevention.

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Drugs Causing Torsades de Pointes

Torsades de Pointes (TdP) is a type of polymorphic ventricular tachycardia often associated with a

prolonged QT interval.

Several drugs can cause or contribute to this condition by prolonging the QT interval. Common drug

classes and examples include:

Antiarrhythmics (Class III and Ia)

1. Class III (Potassium channel blockers)

- Amiodarone (lower risk)

- Sotalol

- Dofetilide

- Ibutilide

2. Class Ia (Sodium channel blockers)

- Quinidine

- Procainamide

- Disopyramide

Antibiotics

- Macrolides: Erythromycin, Clarithromycin

- Fluoroquinolones: Ciprofloxacin, Levofloxacin

Antifungals

- Fluconazole, Voriconazole
Antipsychotics

- Haloperidol

- Chlorpromazine

- Ziprasidone

- Quetiapine

Antidepressants

- Tricyclic antidepressants: Amitriptyline, Imipramine

- SSRIs: Citalopram, Escitalopram

Antiemetics

- Domperidone

- Ondansetron

Others

- Methadone

- Arsenic trioxide

- Chloroquine

- Lithium

Risk Factors

Drug-induced TdP is more likely in the presence of:

- Hypokalemia, hypomagnesemia

- Bradycardia

- Congenital Long QT Syndrome

- Use of multiple QT-prolonging drugs


Close monitoring of QT intervals and correction of electrolytes can help prevent TdP.

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