A Hiccup in Hiccup Management: Cardiac Arrest from Previously Undiagnosed Congenital Long QT Syndrome

Hughes, Robert M.; Sheele, Johnathan M.

doi:10.1155/2018/5023954

Cited by 2 publications

(2 citation statements)

References 13 publications

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“…In the acquired condition, correction of underlying electrolyte abnormalities, withdrawal of QT prolonging medications, and cardioversion may be indicated. Nearly all cases of acquired PQTI are caused by medication-induced blockade of potassium outflow during ventricular repolarization (CredibleMeds, 2018; Hughes & Sheele, 2018; Nachimuthu et al, 2012).…”

Section: Pathophysiology Of the Prolonged Qt Intervalmentioning

confidence: 99%

Prolonged QT Interval in Patients Receiving Psychotropic Medications

Swenson

Murphy-Ende

2019

J Am Psychiatr Nurses Assoc

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INTRODUCTION: Prolonged QT interval (PQTI) is a cardiac condition widely documented in the mental health literature and linked to psychotropic medication use. Medications notable for contributing to the condition are antipsychotics, antidepressants, and some mood stabilizers. Although additional medication classes and other contributing risk factors are often present, the prudent mental health provider benefits from having a basic understanding of this condition and how to prevent and manage it with safe prescribing practices. AIMS: This guide seeks to provide mental health prescribers with a basic understanding of the risk factors, pathophysiology, identification, and management of PQTI. METHOD: Relevant literature and practice guidelines were reviewed and summarized with a focus on practical interventions for the psychiatric mental health nurse practitioner (PMHNP). RESULTS: One of the primary contributing factors to PQTI development and complications is polypharmacy. Patients with co-occurring medical, mental health, and/or substance use disorders may receive medications from multiple providers. Anticancer drugs, antiarrhythmic medications, and even a number of common antibiotics can increase the QT interval, making it a challenge for even the most experienced mental health provider to monitor medication interactions and side effects that contribute to PQTI. Having a sound knowledge base of these factors can guide safe PMHNP practice. CONCLUSIONS: Decision-making trees grounded in evidence-based research were developed in order to direct thorough assessment and safe treatment of patients requiring psychotropic medications.

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Section: Pathophysiology Of the Prolonged Qt Intervalmentioning

confidence: 99%

Prolonged QT Interval in Patients Receiving Psychotropic Medications

Swenson

Murphy-Ende

2019

J Am Psychiatr Nurses Assoc

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“…However, patients in the high‐dose group had an increased risk of side effects and even death (Dudley et al, 2017). In addition, growing evidence indicates that CPZ can lead to arrhythmia, myocardial damage (Kitazawa et al, 1981), corrected QT (QTc) interval prolongation (Zhai et al, 2017), orthostatic hypotension (Leucht et al, 2008) and sudden cardiac death (Hughes & Sheele, 2018; Leonard et al, 2013; Ray et al, 2001). Therefore, to guide drug use and avoid adverse reactions in clinical settings, the toxicological mechanism of CPZ, especially its cardiotoxicity, must be comprehensively explored.…”

Section: Introductionmentioning

confidence: 99%

Role of the heat shock protein family in chlorpromazine‐induced cardiotoxicity

Qishuo

Zhang

et al. 2023

J of Applied Toxicology

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Chlorpromazine (CPZ), a first‐generation antipsychotic, is widely used in treating schizophrenia and other psychiatric disorders. However, CPZ is also associated with an increased likelihood of sudden cardiac death, and the underlying mechanisms remain unclear. In our study, we aimed to determine the CPZ‐induced changes in some members of the heat shock protein family in rat hearts and further explore the possible mechanisms of CPZ‐induced cardiotoxicity. Twenty‐four Sprague Dawley rats were randomly divided into three groups (n = 8 per group): control, low dose (33.216 mg/kg) and high dose (94.211 mg/kg). CPZ administration induced hypothermia in rats. Pathological changes, including ischaemia and hypoxia, were observed in rat hearts. Furthermore, the serum levels of cardiac Troponin T (c‐TN‐T) and brain natriuretic peptide (BNP) were elevated in the CPZ‐exposed groups. Meanwhile, the protein and gene expression of HSP70, HSP60, HSP27 and HSP10 significantly differed between the CPZ‐exposed and control groups. We conclude that acute CPZ exposure could lead to myocardial injury in rats, in which HSPs might play a crucial role. Further investigations are required to elucidate the underlying mechanisms.

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A Hiccup in Hiccup Management: Cardiac Arrest from Previously Undiagnosed Congenital Long QT Syndrome

Cited by 2 publications

References 13 publications

Prolonged QT Interval in Patients Receiving Psychotropic Medications

Prolonged QT Interval in Patients Receiving Psychotropic Medications

Role of the heat shock protein family in chlorpromazine‐induced cardiotoxicity

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