Torsades de pointes: Difference between revisions
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#Isoproterenol (if no pacing, 2-8 mcg/min) | #Isoproterenol (if no pacing, 2-8 mcg/min) | ||
#lidocaine | #lidocaine | ||
==See Also== | |||
*[[Tachycardia (Wide)]] | |||
*[[ACLS Guidelines (2010)]] | |||
==Source == | ==Source == |
Revision as of 23:26, 18 July 2011
Background
Drugs that inhibit P450
- erythromycin
- biaxin
- ketoconozole
- itraconozole
- 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.
Treatment
- 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)
- lidocaine
See Also
Source
10/07 DONALDSON (adapted from Tintinalli, Lampe)