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wikitox:3.2.1.1.10_tachyarrhythmias [2018/09/01 09:00] (current)
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 +====== Tachyarrhythmias ======
 +
 +The most common drugs ingested which prolong QRS & QT intervals and cause tachyarrhythmias are:
 +
 +  * [[:​wikitox:​2.1.11.9.2.1_tricyclic_antidepressants|Tricyclic antidepressants]] *
 +  * [[:​wikitox:​2.1.11.9.3_antipsychotics|Antipsychotic drugs]] (particularly thioridazine) *
 +  * [[:​wikitox:​2.1.11.4.2_antihistamines|Antihistamines]] (particularly terfenadine and astemizole)
 +  * [[:​wikitox:​2.1.11.2_anticonvulsants|Anticonvulsants]] (particularly carbamazepine and phenytoin) *
 +  * [[:​wikitox:​antimalarial_drugs|Antimalarial drugs]] (chloroquine,​ quinine) *
 +  * [[:​wikitox:​3.4.3.4.2_beta_blockers|Beta blockers]] (only propranolol and sotalol) *
 +  * [[:​wikitox:​2.1.6.1.2_cardiac_glycosides|Digoxin]] *
 +  * [[:​wikitox:​3.4.3.4_antiarrhythmics|Antiarrhythmic drugs]] *
 +  * [[:​wikitox:​2.1.11.4.1_anticholinergics|Orphenadrine]] *
 +  * [[:​wikitox:​2.1.11.9.4_mood_stabilizers|Lithium]] *
 +  * [[:​wikitox:​2.1.11.9.1_miscellaneous_anxiolytics_and_sedative_hypnotics|Chloral hydrate]]
 +
 +*These drugs may also cause bradyarrhythmias
 +
 +These drugs are often referred to as having [[:​wikitox:​quinidine_like_effects|'​quinidine-like'​ effects, '​membrane-stabilising'​ properties or '​nonspecific toxicity'​]].
 +
 +For more mechanistic detail and clinical evaluation see [[:​wikitox:​cardiotoxic_drugs|Cardiotoxic Drugs]]
 +
 +
 +===== IN ADDITION =====
 +
 +Adrenergic drugs ([[:​wikitox:​2.1.11.4.8.2_theophylline|theophylline]],​ salbutamol, [[:​wikitox:​2.1.11.4.8.1_cocaine|cocaine]] and amphetamines) cause tachyarrhythmias without causing preceding QRS & QT prolongation.
 +
 +A number of drugs that lead to tissue hypoxia, acidosis or hypoglycaemia ([[:​wikitox:​2.2.9.1.1_carbon_monoxide|CO]],​ [[:​wikitox:​2.2.7.4.4_organochlorines|organochlorines]],​ [[:​wikitox:​2.1.7.1.2_sulphonylureas|hypoglycaemic drugs]], isoniazid, [[:​wikitox:​2.1.1.4_salicylates|salicylates]] etc.) may cause ventricular arrhythmias without marked preceding ECG changes.
 +
 +Features that help to differentiate between these drugs are:
 +
 +[[:​wikitox:​type_of_arrhythmia|TYPE OF ARRHYTHMIA]]\\
 +[[:​wikitox:​level_of_consciousness_prior_to_arrhythmia|LEVEL OF CONSCIOUSNESS PRIOR TO ARRHYTHMIA]]\\
 +[[:​wikitox:​3.1.3_seizures|SEIZURES]]\\
 +[[:​wikitox:​heart_rates|HEART RATE PRIOR TO ARRHYTHMIA]]\\
 +[[:​wikitox:​ecg_changes|ECG CHANGES PRIOR TO ARRHYTHMIA]]\\
 +[[:​wikitox:​pupil_size_and_reaction|PUPIL SIZE & REACTION]]\\
 +[[:​wikitox:​response_to_antagonists|RESPONSE TO ANTAGONISTS]]\\
 +[[:​wikitox:​electrolytes_and_blood_glucose|ELECTROLYTES/​BLOOD GLUCOSE]]\\
 +[[:​wikitox:​blood_concentrations|BLOOD CONCENTRATIONS]]\\
 +\\
 +It is important to try to make the correct diagnosis, as there are [[:​wikitox:​3.4.3.1_cardiac_arrhythmias_and_cardiac_arrest|specific treatments]].
 +
  
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