What is the recommended treatment for the patient whose ECG rhythm shows Torsades de Pointes?
Intravenous magnesium is the first-line pharmacologic therapy in Torsades de Pointes. Magnesium has been shown to stabilize the cardiac membrane, though the exact mechanism is unknown. The recommended initial dose of magnesium is a slow 2 g IV push.
What is used to treat torsades?
The torsades rhythm is treated with magnesium sulfate 2 g IV over 1 to 2 minutes, correction of hypokalemia, pacing or isoproterenol to increase heart rate, and correction of the cause.
Which drug out of the following should be given in a patient who develops torsades de pointes?
Magnesium. Magnesium is recommended for the treatment of torsades de pointes VT with or without cardiac arrest, but it has not been shown to be helpful for treatment of non-torsades pulseless arrest.
Why do you give mag for torsades?
Magnesium sulphate suppresses torsade by decreasing the influx of calcium ions, which in turn results in decreased amplitude of EADs. The initial dose is 2 g (20 ml of 10% solution), given intravenously over one to two minutes.
Is amiodarone contraindicated in torsades?
Torsades de pointes is caused by a prolonged QT. Almost all of the antiarrhythmics that we normally use to treat ventricular tachycardia, such as amiodarone and procainamide, will prolong the QT further, and therefore can make your patient worse. Do not give amiodarone or procainamide.
Does magnesium shorten QT?
Because magnesium does not affect the QT interval, it is not possible to measure response.
Can you use amiodarone for torsades?
How do you reverse torsades de pointes?
Immediate treatment of TdP is by intravenous administration of magnesium sulphate, terminating prolonged episodes using electrical cardioversion. In refractory cases of recurrent TdP, the arrhythmia can be suppressed by increasing the underlying heart rate using isoproterenol (isoprenaline) or transvenous pacing.
How do you give magnesium torsades?
Magnesium can be given at 1-2 g IV initially in 30-60 seconds, which then can be repeated in 5-15 minutes. Alternatively, a continuous infusion can be started at a rate of 3-10 mg/min. Magnesium is effective even in patients with normal magnesium levels.
Why would you not want to give amiodarone to a patient with torsades?
Does amiodarone prolong QT?
Abstract. Amiodarone is an antiarrhythmic agent known to cause prolongation of action potential duration which is reflected in the electrocardiogram as a prolongation of the QT interval.
Which medications are used in the treatment of torsades de pointes?
Pulseless torsades should be defibrillated. Intravenous magnesium is the first-line pharmacologic therapy in Torsades de Pointes. Magnesium has been shown to stabilize the cardiac membrane, though the exact mechanism is unknown.
What is torsades de pointes in ECG?
Torsades de pointes is a form of tachycardia that shows up as a ribbon-like EKG pattern. Problems that occur with the heart’s rhythm are known as arrhythmias. When the heart beats faster than usual, as in a case of torsades de pointes, it is called tachycardia.
Can torsades de pointes cause ventricular fibrillation?
Without treatment, Torsades de Pointes can keep coming back or may lead to ventricular fibrillation, which can be deadly. What is the outlook for Torsades de Pointes?
What drugs cause torsades de pointes in the kidneys?
Drugs known to cause torsades de pointes that require dose adjustment in patients with acute kidney injury or chronic kidney disease • Ciprofloxacin • Disopyramide