Groot JAN, Ten Bokum L, van den Oever HLA Late presentation of torsades de pointes related to fluoxetine following a multiple drug overdose. J Intensive Care. 2018; 6 https://doi.org/10.1186/s40560-018-0329-1
Shah RR Drug-induced QT interval prolongation: does ethnicity of the thorough QT study population matter?. Br J Clin Pharmacol. 2013; 75:347-358 https://doi.org/10.1111/j.1365-2125.2012.04415.x
Wilde AAM, Amin AS, Postema PG Diagnosis, management and therapeutic strategies for congenital long QT syndrome. Heart. 2022; 108:332-338 https://doi.org/10.1136/heartjnl-2020-318259
Schwartz PJ, Stramba-Badiale M, Crotti L, Pedrazzini M, Besana A, Bosi G Prevalence of the congenital long-QT syndrome. Circulation. 2009; 120:1761-1767 https://doi.org/10.1161/CIRCULATIONAHA.109.863209
Finn D, Randall C, Field EA UK Dental Medicines Advisory Service: questions asked by dentists – part 5: prescribing for oromucosal diseases and dry mouth. Br Dent J. 2021; 231:689-695 https://doi.org/10.1038/s41415-021-3681-9
Drug-induced prolongation of the qt interval: implications for dental prescribing Rachel Botrugno E Anne Field Christine Randall Dental Update 2025 52:4, 270-274.
Authors
RachelBotrugno
BDS, MFDS RCPS(Glasg), Specialist Registrar in Oral Medicine, Liverpool University Dental Hospital
Prolongation of the QT interval, as measured on an electrocardiogram, can result in a ventricular arrhythmia known as torsade de pointes (TdP), which can be fatal. Individual drugs and interactions between drugs can pose a risk of QT interval prolongation. Some antimicrobial drugs on the Dental Practitioners' Formulary are associated with a risk of QT interval prolongation. An awareness of QT interval prolongation is critical for safe dental prescribing, particularly for patients with recognized risk factors, including cardiac disease and hepatic/renal impairment.
CPD/Clinical Relevance: For patients at risk of QT interval prolongation, certain antimicrobials that can be prescribed by general dental practitioners have the potential to cause life-threatening cardiac arrhythmias.
Article
Warnings have been issued over the past few years about drugs that are known to cause prolongation of the QT interval, which can result in a potentially life-threatening cardiac arrhythmia.1,2,3
Dentists treating NHS patients can prescribe from an approved list of drugs: the Dental Practitioners' Formulary (DPF).4 Some of the antimicrobial drugs on the DPF are associated with a risk of QT interval prolongation. This article has three aims:
The QT interval, as measured on an electrocardiogram (ECG), represents the time between the start of the Q wave to the end of the T wave. This corresponds to the start of ventricle depolarization to the end of ventricle repolarization (Figure 1). The QT interval varies with the patient's heart rate; as the heart rate increases, the QT interval shortens.
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