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“…Unstable rhythms should be treated electrically with cardioversion or defibrillation according to existing protocols. Successful therapies used in patients with cocaine-induced torsades des pointes include overdrive pacing, magnesium, and lidocaine, but data are insufficient to make firm conclusions about the relative efficacies of these therapies [38,39,43]. The threshold for prophylactic magnesium in stable patients with QT prolongation from cocaine remains unstudied, but we typically advise therapy in those patients with a corrected QT interval above 500 ms, or who fall above the QT-heart rate pair nomogram when heart rate is too high to allow correction using standard formulas [45].…”
Section: Treatment Of Arrhythmias Resulting From Cocaine-associated Pmentioning
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“…Unstable rhythms should be treated electrically with cardioversion or defibrillation according to existing protocols. Successful therapies used in patients with cocaine-induced torsades des pointes include overdrive pacing, magnesium, and lidocaine, but data are insufficient to make firm conclusions about the relative efficacies of these therapies [38,39,43]. The threshold for prophylactic magnesium in stable patients with QT prolongation from cocaine remains unstudied, but we typically advise therapy in those patients with a corrected QT interval above 500 ms, or who fall above the QT-heart rate pair nomogram when heart rate is too high to allow correction using standard formulas [45].…”
Section: Treatment Of Arrhythmias Resulting From Cocaine-associated Pmentioning
“…The QT interval was studied in 45 cocaine users with and without chest pain syndromes [38]. Although only mean values were reported, QT prolongation was common, and three patients with prolonged QT developed torsades de pointes.…”
Section: Potassium Channel Blockadementioning
“…Instead, the cocaine-related cardiac death was most often arrhythmogenic in nature [9,11]. Likewise, significant prolongation of the QTc interval among cocaine users has been reported [15][16][17].…”
Section: Case Reportmentioning
“…2,3 They may also lower the seizure threshold. 4 Furthermore, both cocaine 5,6 and ziprasidone 7,8 prolong the QT interval, which may cause lethal dysrhythmias if combined. We therefore disagree with the authors' assertion that safety is implied in the setting of cocaine toxicity because the use of antipsychotics demonstrates a lack of ''significant adverse events with widespread use.''…”
Section: Use Of Antipsychotics To Treat Cocaine Toxicity?mentioning