In this episode, I’ll discuss whether dexmedetomidine prolongs the QTc interval.
Dexmedetomidine appears to have been added to a list of drugs that possibly prolong the QTc based on a single case report where pediatric use of dexmedetomidine unmasked congenital long QT syndrome. However, there are no published reports of dexmedetomidine use leading to torsades. Additionally, there is a study that reports dexmedetomidine shortened the QT interval during the infusion of a bolus dose.
Because bradycardia is a risk factor for torsades, it is possible that in the pediatric case report bradycardia from dexmedetomidine is what triggered the unmasked congenital long QT syndrome rather than a direct effect on the QTc
In my opinion, the available data is too weak and conflicting to raise a concern about the potential of dexmedetomidine to prolong the QT interval in adult critically ill patients.
Members of my Hospital Pharmacy Academy have access to practical, in-depth training on the use of dexmedetomidine in critical care as well as many other resources to help in everyday practice. To get immediate access, go to pharmacyjoe.com/academy.
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