Ep 18 – Managing the risk of drug-induced QT prolongation in primary care

In the first episode in a new season of the podcast, Kevin discusses helpful guidance on the corrected QT interval in the context of primary care prescribing. Why should we be concerned about prolongation of the QT interval? Which medications can affect QT interval? What other risk factors for QT prolongation should be considered? And for which patients should we recommend electrocardiogram monitoring?

Key references and resources discussed in the episode:

• Drugs & Therapeutics Bulletin article on QT interval and drug therapy (also re-published in the BMJ)
• CredibleMeds website
• Calculator for correcting the QT interval

Key take-home points from the episode include:

1. The risk of a prolonged QTc interval and torsades de pointes depends on patient clinical factors such as electrolyte disturbance or a history of cardiovascular disease, as well as medication history.
2. CredibleMeds is a useful website categorising drugs by their potential to prolong the QTc interval.
3. Electrocardiogram monitoring should be considered on an individual basis for those at highest risk.