A literature-based algorithm for the assessment, management, and monitoring of drug-induced QTc prolongation in the psychiatric population

M Zolezzi,1 L Cheung2 1Division of Clinical Pharmacy and Practice, College of Pharmacy, Qatar University, Doha, Qatar; 2Pharmacy Department, Grey Nuns Community Hospital, Edmonton, AB, Canada Background: Certain psychotropics and a number of other medications used to treat medical conditions in ps...

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Autores principales:	Zolezzi M, Cheung L
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2018
Materias:	Drug-induced arrhythmias/QT interval/torsades de pointes guidelines/protocol/algorithm mental/psychiatric patients Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/8f98136d95b54a3a9e3b007b42ecc8ad
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spelling	oai:doaj.org-article:8f98136d95b54a3a9e3b007b42ecc8ad2021-12-02T09:23:31ZA literature-based algorithm for the assessment, management, and monitoring of drug-induced QTc prolongation in the psychiatric population1178-2021https://doaj.org/article/8f98136d95b54a3a9e3b007b42ecc8ad2018-12-01T00:00:00Zhttps://www.dovepress.com/a-literature-based-algorithm-for-the-assessment-management-and-monitor-peer-reviewed-article-NDThttps://doaj.org/toc/1178-2021M Zolezzi,1 L Cheung2 1Division of Clinical Pharmacy and Practice, College of Pharmacy, Qatar University, Doha, Qatar; 2Pharmacy Department, Grey Nuns Community Hospital, Edmonton, AB, Canada Background: Certain psychotropics and a number of other medications used to treat medical conditions in psychiatric patients can increase the risk of prolonging the corrected QT (QTc) interval on the electrocardiogram, which puts patients at risk of life-threatening ventricular arrhythmias such as torsades de pointes. Pharmacists are often consulted about medications which are known to prolong the QTc interval. Although this information is often accessible, advising how to identify, assess, manage, and refer psychiatric patients at risk for drug-induced QTc prolongation is more challenging. Objectives: The objective of this project was first to review the literature, which describes guidelines and recommendations for the assessment and management of drug-induced QTc prolongation, and then to design an algorithm to be used by pharmacists working closely with mental health professionals or who provide care to psychiatric patients. Methods: A review of the literature was undertaken. Predefined keywords were used to perform the database search in MEDLINE, EMBASE, and International Pharmaceutical Abstracts to identify reviews, reports and guidelines on the assessment, prevention and monitoring of drug-induced QTc prolongation with an emphasis on psychotropic medications and management in the psychiatric population. Results: The electronic database search retrieved 637 relevant citations. These were initially screened by title and all duplicates were removed. The abstracts were then reviewed for relevancy based on the inclusion/exclusion criteria. Additional citations were retrieved from the bibliography of the articles identified in the initial search. A total of 79 articles describing QTc prolongation in the psychiatric population were thoroughly examined, but only 31 articles were selected to guide the development of the algorithm. Conclusion: The literature-based algorithm developed provides a stepped-based approach for the assessment, monitoring, and management of drug-induced QTc prolongation in the psychiatric population. The algorithm may assist mental health clinicians in the decision-making process when psychiatric patients are prescribed medications known to increase the QTc interval. Keywords: drug-induced arrhythmias, QT interval, torsades de pointes, guidelines, protocol, algorithm, mental, patientsZolezzi MCheung LDove Medical PressarticleDrug-induced arrhythmias/QT interval/torsades de pointesguidelines/protocol/algorithmmental/psychiatric patientsNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571Neurology. Diseases of the nervous systemRC346-429ENNeuropsychiatric Disease and Treatment, Vol Volume 15, Pp 105-114 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	Drug-induced arrhythmias/QT interval/torsades de pointes guidelines/protocol/algorithm mental/psychiatric patients Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
spellingShingle	Drug-induced arrhythmias/QT interval/torsades de pointes guidelines/protocol/algorithm mental/psychiatric patients Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429 Zolezzi M Cheung L A literature-based algorithm for the assessment, management, and monitoring of drug-induced QTc prolongation in the psychiatric population
description	M Zolezzi,1 L Cheung2 1Division of Clinical Pharmacy and Practice, College of Pharmacy, Qatar University, Doha, Qatar; 2Pharmacy Department, Grey Nuns Community Hospital, Edmonton, AB, Canada Background: Certain psychotropics and a number of other medications used to treat medical conditions in psychiatric patients can increase the risk of prolonging the corrected QT (QTc) interval on the electrocardiogram, which puts patients at risk of life-threatening ventricular arrhythmias such as torsades de pointes. Pharmacists are often consulted about medications which are known to prolong the QTc interval. Although this information is often accessible, advising how to identify, assess, manage, and refer psychiatric patients at risk for drug-induced QTc prolongation is more challenging. Objectives: The objective of this project was first to review the literature, which describes guidelines and recommendations for the assessment and management of drug-induced QTc prolongation, and then to design an algorithm to be used by pharmacists working closely with mental health professionals or who provide care to psychiatric patients. Methods: A review of the literature was undertaken. Predefined keywords were used to perform the database search in MEDLINE, EMBASE, and International Pharmaceutical Abstracts to identify reviews, reports and guidelines on the assessment, prevention and monitoring of drug-induced QTc prolongation with an emphasis on psychotropic medications and management in the psychiatric population. Results: The electronic database search retrieved 637 relevant citations. These were initially screened by title and all duplicates were removed. The abstracts were then reviewed for relevancy based on the inclusion/exclusion criteria. Additional citations were retrieved from the bibliography of the articles identified in the initial search. A total of 79 articles describing QTc prolongation in the psychiatric population were thoroughly examined, but only 31 articles were selected to guide the development of the algorithm. Conclusion: The literature-based algorithm developed provides a stepped-based approach for the assessment, monitoring, and management of drug-induced QTc prolongation in the psychiatric population. The algorithm may assist mental health clinicians in the decision-making process when psychiatric patients are prescribed medications known to increase the QTc interval. Keywords: drug-induced arrhythmias, QT interval, torsades de pointes, guidelines, protocol, algorithm, mental, patients
format	article
author	Zolezzi M Cheung L
author_facet	Zolezzi M Cheung L
author_sort	Zolezzi M
title	A literature-based algorithm for the assessment, management, and monitoring of drug-induced QTc prolongation in the psychiatric population
title_short	A literature-based algorithm for the assessment, management, and monitoring of drug-induced QTc prolongation in the psychiatric population
title_full	A literature-based algorithm for the assessment, management, and monitoring of drug-induced QTc prolongation in the psychiatric population
title_fullStr	A literature-based algorithm for the assessment, management, and monitoring of drug-induced QTc prolongation in the psychiatric population
title_full_unstemmed	A literature-based algorithm for the assessment, management, and monitoring of drug-induced QTc prolongation in the psychiatric population
title_sort	literature-based algorithm for the assessment, management, and monitoring of drug-induced qtc prolongation in the psychiatric population
publisher	Dove Medical Press
publishDate	2018
url	https://doaj.org/article/8f98136d95b54a3a9e3b007b42ecc8ad
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A literature-based algorithm for the assessment, management, and monitoring of drug-induced QTc prolongation in the psychiatric population

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