Torsades de pointes

Question 1

hemodynamically stable, no signs of heart failure, first-line treatment for torsade’s de pointes ?

Answer 1

Intravenous magnesium sulphate.

Question 2

an opioid antagonist used to reverse the effects of opioids such as respiratory depression?

Answer 2

Intravenous naloxone

Question 3

hemodynamically unstable or experiencing ongoing ischemia due to the arrhythmia. first-line treatment for torsade’s de pointes ?

Answer 3

DC cardioversion

Question 4

Intravenous amiodarone is not typically recommended as a first-line treatment for torsades de pointes . WHY?

Answer 4

Due to its potential to prolong the QT interval further, which could exacerbate the condition.

Question 5

Intravenous verapamil has no role in treating torsades de pointes . WHY?

Answer 5

Verapamil is a calcium channel blocker primarily used for rate control in atrial fibrillation and managing supraventricular tachycardias.

It has no role in treating torsades de pointes and could potentially worsen the patient’s condition by causing hemodynamic instability or further arrhythmias.

Question 6

Causes of long QT interval

Answer 6

A - Antiarrhythmics
Amiodarone
Sotalol
Class 1a (Quinidine, Procainamide, Disopyramide)

B - Brain Conditions
Subarachnoid Hemorrhage
Hypothermia

C - Congenital Syndromes
Congenital (Jervell-Lange-Nielsen, Romano-Ward)

D - Drugs (Psych & Infection-related)
Depressants (Tricyclic Antidepressants - TCAs)
Delirium meds (Antipsychotics - Haloperidol, Chlorpromazine)
Drugs for malaria (Chloroquine)
Drugs for allergies (Terfenadine - withdrawn)
Drugs for infections (Erythromycin)

E - Electrolyte Imbalances
HypoElectrolytes (Hypocalcemia, Hypokalemia, Hypomagnesemia)

QT - The condition itself (Prolonged QT!)