Ann Pharmacol Pharm | Volume 1, Issue 1 | Research Article | Open Access

Increasing Risk Awareness for Torsades De Pointes: Evaluating QTc-Prolonging Medication use and ECG Monitoring in Hospitalized Patients

Kobi T Nathan1,2*, William Darko3, Luke A Probst3 and Christopher Miller3

1Department of Pharmacy Practice, Wegmans School of Pharmacy, USA
2Department of Pharmacy Practice, St. John Fisher College, USA
3Department of Pharmacy Practice, SUNY Upstate Medical University, USA

*Correspondance to: Kobi T Nathan 

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Abstract

Purpose: The objectives of this study were to describe the prevalence of QTc-prolonging medication exposures among hospitalized patients and examine the association between QTc-prolonging medication exposure and new onset QTc-prolongation.
Methods: A retrospective cohort study was conducted among a convenience sample of patients hospitalized at Upstate University Hospital during a 6 month time period. Data including patient demographics, medication exposures, and ECG results were collected. Patients with a diagnosis of bundle branch block were excluded. Medications were categorized according to three risk groups for Torsades de Pointes: risk, conditional risk, and possible risk. An abnormal QTc interval was defined as >430 for men and >450 for women. Data were analyzed using SPSS statistical software.
Results: One hundred fifty patients were included. Mean age was 62 years (SD, 11.9), 80 patients (53.3%) were female, and the majority of patients were Caucasian (46.3%) or African American (38.3%). Ninety seven (64.7%) patients were prescribed medication associated with some risk for QTc prolongation, including 47 patients (31.3%) who were concurrently prescribed 2 or more QTcprolonging medications. An EKG was performed in 112 (74.7%) patients and 76 (50.7%) had an abnormal QTc interval. Most abnormal QTc intervals were found upon admission with 9 patients experiencing new onset QTc prolongation during hospitalization. No significant association was found between QTc medication exposure and new onset QTc prolongation.
Conclusion: Hospitalized patients are at high risk for single and multiple QTc medication exposures. Although a substantial number of patients had an abnormal QTc interval, most were discovered upon admission and few experienced new onset QTc prolongation. A significant association between medication exposure and new onset QTc prolongation was not detected in this study.

Keywords:

QTc-prolonging medications; Electrocardiogram

Citation:

Nathan KT, Darko W, Probst LA, Miller C. Increasing Risk Awareness for Torsades De Pointes: Evaluating QTc- Prolonging Medication use and ECG Monitoring in Hospitalized Patients. Ann Pharmacol Pharm. 2016; 1(1): 1002.

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