Difference between revisions of "Torsades de pointes"
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*[[ACLS (2010 )]]
Revision as of 23:26, 18 July 2011
Drugs that inhibit P450
- certain antihistamines like terfandadine or astemizole, inhibit the delayed rectifier potassium channel
- terfenadine is completely metabolized in liver. Once metabolized, has no cardiac activity
- unmetabolized terfenadine has quinidine- like activity- gives torsades
- if P450 enz inhibited by other drug, then will have increase in concentration of unmetabolized terfanadine.
- Mg (1-2gm over 1-2 minutes; then, 1-2gm/hr gtt)
- Overdrive pacing (hr = 90-120)
- Isoproterenol (if no pacing, 2-8 mcg/min)
10/07 DONALDSON (adapted from Tintinalli, Lampe)