Torsades de Pointes
- 1st Edition - March 17, 2022
- Imprint: Academic Press
- Editor: James E. Tisdale
- Language: English
- Paperback ISBN:9 7 8 - 0 - 1 2 - 8 2 1 4 4 6 - 6
- eBook ISBN:9 7 8 - 0 - 1 2 - 8 2 1 4 6 1 - 9
Over the past 25-30 years, deaths due to Torsades de Pointes (TdP) have resulted in numerous drugs being withdrawn from the market. However, nearly 200 drugs that may prolong th… Read more
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Request a sales quoteOver the past 25-30 years, deaths due to Torsades de Pointes (TdP) have resulted in numerous drugs being withdrawn from the market. However, nearly 200 drugs that may prolong the QT interval and cause TdP remain available. A number of drugs with the potential to cause TdP are among the top 200 most prescribed drugs in the US, whilst new information regarding TdP is emerging rapidly. The purpose of this book is to provide a comprehensive source of information on the topic of torsades de pointes (TdP), which is a life-threatening polymorphic ventricular tachyarrhythmia associated with QT interval prolongation on the electrocardiogram (ECG).
Torsades de Pointes provides a detailed, up-to-date and emerging information related to the epidemiology, drug culprits, mechanisms, risk factors, and methods of prevention and management of the life-threatening polymorphic ventricular tachycardia, also known as torsades de pointes. The book contains current knowledge, incorporating recent and cutting-edge advances in understanding of topics including inherited channelopathies and congenital LQTS; drugs that cause QT interval prolongation and TdP; non-drug causes of acquired QT interval prolongation and TdP; epidemiology of inherited and acquired TdP; morbidity and mortality associated with TdP, particularly in association with specific antimicrobials, antidepressants and antipsychotics, and methadone; cellular and molecular mechanisms of TdP, traditional and emerging risk factors for TdP; methods of prevention and risk reduction for TdP; and clinical management of patients with TdP.
This book is an essential reference for both clinicians and researchers – providing guidance for clinicians who care for patients receiving QT interval-prolonging drugs, as well as cutting edge information for scientists and investigators conducting research in the area.
- Up-to-date information on TdP associated with inherited channelopathies and the multiple forms of congenital LQTS
- Includes a wealth of new information emerging regarding TdP, including newly-described risk factors and cellular and molecular mechanisms, contributions of genetic polymorphisms to drug-induced TdP, methods of quantification of risk, and methods of risk reduction, including clinical decision support
- Contains information on nearly 200 commonly used drugs that have the potential to cause torsades de pointes, including antimicrobials, antipsychotics, antidepressants, antiarrhythmic agents, methadone, and many others
- An essential reference for clinicians and researchers – provides guidance for clinicians who care for patients receiving QT interval-prolonging drugs, as well as cutting edge information for scientists and investigators conducting research in the area
Health care professionals (cardiologists, cardiac electrophysiologists, other physicians, pharmacists, nurses and others) who care for patients with inherited channelopathies, and who care for patients receiving drug therapy of any type that may cause QT interval prolongation and TdP. Can serve as a textbook for students in colleges of medicine and pharmacy, and potentially for students in colleges devoted to other health professions and sciences as well. Could be useful to pharmacologists too
- Cover
- Title page
- Table of Contents
- Copyright
- Dedication
- Contributors
- Preface
- Chapter 1: Overview of torsades de pointes
- Abstract
- Introduction
- Definitions and descriptions of TdP
- Overview of LQTS and TdP
- Epidemiology of TdP
- Consequences of LQTS and TdP
- Future directions
- References
- Chapter 2: Torsades de pointes associated with inherited channelopathies
- Abstract
- Introduction
- Long QT syndrome
- Acquired LQTS and the link to congenital LQTS
- Torsades de pointes arrhythmias
- Short-coupled torsades de pointes arrhythmia
- Conclusions
- References
- Chapter 3: Drug-induced torsades de pointes
- Abstract
- Introduction
- Medications as a cause of TdP
- Drug-induced QT interval prolongation and prediction of TdP risk
- Determining causality for drug-induced QT interval prolongation and TdP: The adverse drug event causality analysis (ADECA) process
- Evidence requirements for risk categories
- Scientific validation of the QTdrugs list and the ADECA process
- Frequency of prescription of QT interval-prolonging medications
- Epidemiology of TdP and death associated with QT interval-prolonging drugs
- Management of risk of drug-induced QT prolongation and TdP
- Conclusion
- References
- Chapter 4: Mechanisms of torsades de pointes
- Abstract
- Acknowledgments
- Introduction
- A brief introduction to ventricular action potential electrogenesis, including INa, IKs, and IKr
- Drugs linked to torsades de pointes in humans and the association with IKr/hERG block
- A role for pharmacological activation of late sodium current in diLQTS
- IKs and repolarization reserve
- Cellular arrhythmogenic events resulting from action potential prolongation: Early afterdepolarizations
- How is torsades de pointes initiated and maintained?
- Moderating factors for drug-induced torsades de pointes
- Conclusions
- References
- Chapter 5: Traditional risk factors for QT interval prolongation and torsades de pointes
- Abstract
- Introduction
- Risk factors for QT interval prolongation and torsades de pointes
- Summary and conclusions
- References
- Chapter 6: Emerging risk factors for QT interval prolongation and torsades de pointes
- Abstract
- Introduction
- Acquired factors
- Genetic factors
- Conclusions and clinical perspectives
- References
- Chapter 7: Predictive analytics for reducing the risk of QT interval prolongation and torsades de pointes
- Abstract
- Predictive analytics for assessing the risk of QT interval prolongation
- Predictive analytics for assessing risk of torsades de pointes and/or sudden cardiac death
- Incorporation of predictive analytics into clinical decision support tools
- Summary and conclusions
- References
- Chapter 8: Antiarrhythmic agents and torsades de pointes
- Abstract
- Introduction
- Classes of antiarrhythmic drugs
- Class I antiarrhythmic drugs
- Class III antiarrhythmic drugs
- Other antiarrhythmic drugs
- Conclusions
- References
- Chapter 9: Psychotropic agents and torsades de pointes
- Abstract
- Introduction
- Antidepressants
- Antipsychotics
- Mood stabilizers
- Stimulants and stimulant-like medications
- Other psychotropic medications
- Conclusion
- References
- Chapter 10: Antimicrobial agents and torsades de pointes
- Abstract
- Introduction
- Antibacterial agents
- Antifungal drugs
- Antimalarial agents
- Antiviral drugs
- Antitubercular drugs
- Other antimicrobial agents
- Practical considerations
- Conclusion
- References
- Chapter 11: Methadone, synthetic opioids and torsades de pointes
- Abstract
- Acknowledgment
- Introduction
- Epidemiology and mechanisms of opioid-associated mortality
- Methadone and arrhythmia potential
- Additional synthetic opioids and arrhythmia potential
- Nonprescription drugs and arrhythmia potential
- Gaps in understanding opioid-associated cardiotoxicity and future directions
- Conclusions
- References
- Chapter 12: Torsades de pointes in patients with cancer
- Abstract
- Measurement of the QT interval in the cancer population
- Pathophysiology of QT interval prolongation
- Cancer therapies associated with QT interval prolongation and torsades de pointes
- Management of QT interval prolongation in patients with cancer
- Conclusion
- References
- Chapter 13: Strategies for prevention and management of QT interval prolongation and torsades de pointes
- Abstract
- Introduction
- Prevention of QT interval prolongation and torsades de pointes
- Management of torsades de pointes
- Investigational strategies and potential future approaches
- References
- Chapter 14: Important unanswered research questions related to torsades de pointes
- Abstract
- Introduction
- Missing and complex inheritance of QT interval prolongation and torsades de pointes
- Clinical diagnosis and risk stratification in torsades de pointes susceptibility
- Evolving mechanisms and precision therapies for torsades de pointes
- Conclusions
- References
- Index
- Edition: 1
- Published: March 17, 2022
- No. of pages (Paperback): 376
- No. of pages (eBook): 376
- Imprint: Academic Press
- Language: English
- Paperback ISBN: 9780128214466
- eBook ISBN: 9780128214619
JT
James E. Tisdale
Prof. Tisdale is a Professor of Pharmacy at Purdue University and an Adjunct Professor under the School of Medicine at Indiana University. His main research focus is studying drugs that cause torsades de pointes (TdP) and methods of prevention and reducing the risk of drug-induced TdP. He has published more than 100 journal articles and book chapters, with an emphasis on the topic of drug-induced QT interval prolongation and TdP. He is also a fellow of the American Heart Association, the American College of Clinical Pharmacy, the American Pharmacists Association, and the National Academies of Practice.
Affiliations and expertise
Professor, College of Pharmacy, Purdue University; Adjunct Professor, School of Medicine, Indiana University, Indianapolis, IN, USARead Torsades de Pointes on ScienceDirect