(FIT)-Module 4 Workshop 7: Electrocradiogrpahic and Electrophysiological Correlations, Atrial Fibrillation, Clinical Scenarios and Syndromes-Poole Case 4 Answer

Video Transcription

Video Summary

The video discusses a case of atrial pacing with a significantly prolonged QT interval. It highlights loperamide, an over-the-counter medication used illicitly for opioid withdrawal, which can cause QT prolongation, particularly at high doses by blocking IKR. Additionally, substances inhibiting P-glycoprotein and CYP3A4 enzymes exacerbate this risk by delaying loperamide metabolism. The patient also takes citalopram, known for dose-dependent QT interval prolongation by IKR inhibition, and has hypokalemia, both contributing to the risk of QT prolongation.

Keywords

atrial pacing

prolonged QT interval

loperamide

IKR blockade

hypokalemia