Department of Medicine, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, India.
Kathmandu Univ Med J (KUMJ). 2023 Jul-Sep;21(83):298-303.
Background It was Dissertenne who first described a cardiac phenomenon known as the Torsades de Pointes (TdP). QT prolongation caused by drugs is one of the most important causes for acquired QT prolongation syndrome. Objective To observe the prescribing practices of QT interval prolonging drugs among a highrisk population of critically ill older adults in a tertiary care hospital in South India The objectives were to identify the most commonly prescribed QT prolonging drugs, to analyse types of QT prolonging drugs based on risk of causing QT prolongation, to study the frequency of occurrence of common risk factors for QT prolongation and to identify presence of any significant relationships among the study variables. Method We have conducted a one-year cross-sectional descriptive study of the prescribing practices of QT interval prolonging drugs among 319 critically ill older adults in a tertiary care hospital in South India. Data was analysed to categorize the most common drugs which prolong QT interval; the type and frequency of use of QT interval prolonging drugs and to find the most common risk factors for QT prolongation in this study population. Result In this study, ondansetron, clarithromycin, azithromycin,and amiodarone were the most prescribed among the drugs with known risk of QTc (Corrected QT interval) prolongation. Among the drugs with conditional risk of QTc prolongation, pantoprazole, frusemide, piperacillin-tazobactam and esomeprazole were the most prescribed. The most common risk factors for QTc prolongation that were identified in this study were bradycardia, acute kidney injury, chronic kidney disease and low serum potassium. Conclusion This study helps to inform our physicians regarding the commonly prescribed QT interval prolonging drugs so that they may reduce co prescription of multiple QT prolonging drugs in high-risk patients. It identifies kidney injury, low potassium, and bradycardia as common risk factors for QT interval prolongation in these patients.
迪森特内（Dissertenne）首次描述了一种名为尖端扭转型室性心动过速（TdP）的心脏现象。药物引起的 QT 间期延长是获得性 QT 延长综合征的最重要原因之一。目的：观察印度南部一家三级护理医院重症老年高危人群中 QT 间期延长药物的处方实践。目的是确定最常开的 QT 延长药物，根据引起 QT 延长的风险分析 QT 延长药物的类型，研究 QT 延长常见危险因素的发生频率，并确定研究变量之间是否存在任何显著关系。方法：我们对印度南部一家三级护理医院的 319 名重症老年患者的 QT 间期延长药物的处方实践进行了为期一年的横断面描述性研究。对数据进行分析，以分类最常见的延长 QT 间期的药物；QT 间期延长药物的类型和使用频率，并在该研究人群中寻找 QT 延长最常见的危险因素。结果：在这项研究中，昂丹司琼、克拉霉素、阿奇霉素和胺碘酮是已知有 QTc（校正 QT 间期）延长风险的药物中最常开的药物。在有条件性 QTc 延长风险的药物中，泮托拉唑、呋塞米、哌拉西林他唑巴坦和埃索美拉唑是最常开的药物。在这项研究中确定的 QT 延长最常见的危险因素是心动过缓、急性肾损伤、慢性肾脏病和低血钾。结论：这项研究有助于向我们的医生提供有关常用 QT 间期延长药物的信息，以便他们可以减少高危患者中多种 QT 延长药物的联合处方。它确定了肾损伤、低钾血症和心动过缓是这些患者 QT 间期延长的常见危险因素。
