Longing for the QT

A 58-year-old man presented to the ED with a reported overdose of an unknown medication. The patient was agitated, combative, and altered. Initial vital signs included a heart rate of 115 beats/min, blood pressure of 154/93 mm Hg, respirations of 22/min, and temperature of 99.5°F. The patient was difficult to evaluate because he was agitated, and he was given 5 mg of haloperidol IV and 2 mg of lorazepam IV. The patient continued to be agitated, and was given another 10 mg of haloperidol IV, followed by a repeat dose of 10 mg IV 15 minutes later. The patient then became unresponsive, and his cardiac monitor demonstrated the rhythm below.​What is the mechanism of drug-induced QT prolongation?The causes of QT prolongation can be divided into congenital and acquired. These two entities occur by different mechanisms. Congenital prolonged QT syndrome is caused by, mutations in ion channel subunits or protein coding genes. The acquired form is more prevalent with drug-induced QT prolongation being the most frequent cause.Most drugs that prolong the QT interval act by blocking the delayed rectifier potassium channel encoded by the human ether à go-go related gene (hERG). This inhibits the flow of potassium ions through the outward potassium channel, thereby delaying depolarization. Contributing factors include higher drug serum levels, polypharmacy, electrolyte abnormalities (hypokalemia, hypomagnesemia, hypocalcemia), genetic factors, intrinsic heart disease, and dysrhy...
Source: The Tox Cave - Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

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Source: World of Psychology - Category: Psychiatry & Psychology Authors: Tags: Addiction General Mental Health and Wellness Not Crazy Podcast Recovery Source Type: blogs
When it comes to health concerns, the COVID-19 pandemic is top of mind for most people right now. And that’s for good reason. But there is some very good non-COVID health news that may not be getting the attention it deserves. According to the CDC, the rates of six of the top 10 causes of death in this country, which account for about three-quarters of all deaths, have been declining. That’s remarkable. And these improvements are occurring despite an aging population and an obesity epidemic that affects several health conditions. Six positive health trends Let’s look at the trends in these conditions...
Source: Harvard Health Blog - Category: Consumer Health News Authors: Tags: Cancer Health Health trends Heart Health Source Type: blogs
p.p1 {margin: 0.1px 0.0px 0.1px 0.1px; font: 9.0px Helvetica}An elderly woman with history of coronary disease presented with CP and SOB and hypotension by EMS.  EMS had attempted adenosine x 2 without success.Here is her ED ECG:Here is the ED physician's interpretation:IMPRESSIONUNCERTAIN REGULAR RHYTHM, wide complex tachycardia, likely p-waves.LEFT BUNDLE BRANCH BLOCK [120+ ms QRS DURATION, 80+ ms Q/S IN V1/V2, 85+ ms R IN I/aVL/V5/V6]Comparison Summary: LBBB and tachycardia are new.What do you think?Smith:  This is indeed a regular wide complex tachycardia.  I do not see P-waves.  Retrograde P-w...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs
If you were to sum up the overall health of a nation in one single number, what would that be? At the top of the list, you would likely find average life expectancy — the total number of years, on average, that a person in a country can expect to live. Wars, famine, and economic crises are expected to lower life expectancy. Breakthroughs in science, strong economies, and behaviors like eating a healthy diet, exercising, and avoiding tobacco typically raise average life expectancy. An amazing rise, a surprising fall Between 1959 and 2014, the United States experienced an unprecedented increase in life expectancy, whic...
Source: Harvard Health Blog - Category: Consumer Health News Authors: Tags: Addiction Health Health care disparities Men's Health Women's Health Source Type: blogs
BOSTON (CBS) — In 2018, life expectancy increased for the first time in four years, according to the Centers of Disease Control. The average American can now expect to live about 78.7 years, up 0.1 years from the year before. The rise is largely due to a drop in overdose deaths by 4%, but also from fewer deaths from several other leading causes of death, including heart disease and cancer. While cautiously optimistic, public health officials worry that this slight uptick in life expectancy might be an aberration. For example, while deaths from heroin and prescription drugs have fallen, those from cocaine and syntheti...
Source: WBZ-TV - Breaking News, Weather and Sports for Boston, Worcester and New Hampshire - Category: Consumer Health News Authors: Tags: Boston News Health Healthwatch Syndicated CBSN Boston Syndicated Local CDC Dr. Mallika Marshall Health News Life Expectancy Source Type: news
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Source: TIME: Health - Category: Consumer Health News Authors: Tags: Uncategorized health onetime overnight Source Type: news
Analysis of 2018 data by the CDC reveals that deaths from cancer, heart disease and other leading causes have either declined or remained unchanged -- including the first decrease for overdose deaths in 28 years.
Source: Health News - UPI.com - Category: Consumer Health News Source Type: news
According to a new study by SeniorLiving.org on Life Expectancy In Every U.S. State, Hawaii is the No. 1 state in America, with the highest life expectancy of 81.3 years old in 2018.  California is next on the list at 80.9 and Mississippi is the lowest at 74.7. U.S. life expectancy declined nationally for the third consecutive year in 2018 due to increases not only in cancer and heart disease, as the two biggest causes of death in America, but also suicide, drug overdoses and liver disease connected…
Source: bizjournals.com Health Care:Pharmaceuticals headlines - Category: Pharmaceuticals Authors: Source Type: news
In this report, we characterize the case of a 23-year-old male regular drug user who died a few hours after NEH and ADB-FUBINACA consumption. His medical history showed arrhythmia in childhood, and some seizures. Autopsy found he had a BMI of 42.9, a hypertrophic and dilated heart, severe atherosclerosis of the valves, coronaries and the arteries, and edema of the internal organs. Histology confirmed those findings. Postmortem blood levels of NEH were 285 ng/ml, along with 0.08 ng/ml ADB-FUBINACA and five ADB-FUBINACA metabolites. Based on the blood concentrations measured in suspected drug users (≤83.9 ng/ml) we ...
Source: Journal of Forensic and Legal Medicine - Category: Forensic Medicine Source Type: research
In this report, we characterize the case of a 23-year-old male regular drug user who died a few hours after NEH and ADB-FUBINACA consumption. His medical history showed arrhythmia in childhood, and some seizures. Autopsy found he had a BMI of 42.9, a hypertrophic and dilated heart, severe atherosclerosis of the valves, coronaries and the arteries, and edema of the internal organs. Histology confirmed those findings. Postmortem blood levels of NEH were 285 ng/ml, along with 0.08 ng/ml ADB-FUBINACA and five ADB-FUBINACA metabolites. Based on the blood concentrations measured in suspected drug users (≤ 83.9 ng/ml) we hypot...
Source: Journal of Forensic and Legal Medicine - Category: Forensic Medicine Source Type: research
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