Critical Care >Pharmacology in Critical Illness

John M. Oropello, Stephen M. Pastores, Vladimir Kvetan+

Table 15–4Medications associated with prolonged QT intervala in ICUs (not all inclusive).

Analgesics—Methadone

Antiarrhythmic agents

Amiodarone

Dofetilide

Ibutilide

Procainamide

Quinidine

Sotalol

Anesthetics

Inhaled—Halothane, Enflurane, Isoflurane, Sevoflurane

Intravenous—Thiopental

Antidepressants

Tricyclics—Imipramine, etc

SSRIsb—Citalopram, Fluoxetine, Venlafaxine

Antimicrobial agents

Fluoroquinolones—Levofloxacin >Moxifloxacin >Ciprofloxacin

Macrolides—Erythromycin (esp. high-dose IV) >Clarithromycin >Azithromycin

Azole antifungalsc—(Ketoconazole, Itraconazole) >voriconazole >Fluconazole

Antipsychotics

Butyrophenones—Droperidol, Haloperidol

Clozapine

Olanzapine

Phenothiazines—Thioridazine, etc

Quetiapine

Risperidone

Ziprasidone
 Antiemetics

5-HT3 antagonists—Dolasetron >Ondansetron

Droperidol

Neuromuscular blocking and reversal agents

Succinylcholine

Atropine, Glycopyrrolate, Neostigmine

aRisk is increased with higher dose or repeated doses in short period of time; risk is also increased in drug overdose.

bSSRIs: selectiveserotonin reuptake inhibitors.

cAzoles usually cause prolonged QT interval through interaction with another agent with QT prolongation potential.

Date of download: 01/01/23 from AccessMedicine: accessmedicine.mhmedical.com, Copyright © McGraw Hill. All rights reserved.