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Date of download: 6/2/2016 From: Torsade de Pointes Associated with the Use of Intravenous Haloperidol Ann Intern Med. 1993;119(5):391-394. doi:10.7326/0003-4819-119-5-199309010-00007.

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Presentation on theme: "Date of download: 6/2/2016 From: Torsade de Pointes Associated with the Use of Intravenous Haloperidol Ann Intern Med. 1993;119(5):391-394. doi:10.7326/0003-4819-119-5-199309010-00007."— Presentation transcript:

1 Date of download: 6/2/2016 From: Torsade de Pointes Associated with the Use of Intravenous Haloperidol Ann Intern Med. 1993;119(5):391-394. doi:10.7326/0003-4819-119-5-199309010-00007 Sequential tracings for patient 1 with corresponding QTc intervals.111Values are expressed in milliseconds (ms). All tracings were averaged at the time of measurement. The baseline strip (A, standard lead II) and tracings at 4 hours (B, standard lead II), 48 hours (C, standard lead II), and 72 hours (D, lead MCL ) after starting intravenous haloperidol are shown. A sample of the torsade de pointes (TdP) is shown in tracing E (lead MCL ). The QTc gradually returned to baseline after discontinuing the haloperidol; a representative strip from 6 days later (F, lead MCL ) is shown. Figure Legend: Copyright © American College of Physicians. All rights reserved.American College of Physicians

2 Date of download: 6/2/2016 From: Torsade de Pointes Associated with the Use of Intravenous Haloperidol Ann Intern Med. 1993;119(5):391-394. doi:10.7326/0003-4819-119-5-199309010-00007 Sequential tracings for patient 2 with corresponding QTc intervals.Values are expressed in milliseconds (ms). Standard lead II is shown in all tracings. All tracings were averaged at the time of measurement. A baseline strip (A) and a tracing at 12 hours (B) after initiating intravenous haloperidol are shown. Note the prolonged QTc interval at baseline. A sample of the torsade de pointes (TdP) is shown in tracing C. Atrial pacing was instituted (D) and eventually discontinued. The QTc interval gradually returned to below baseline; a representative strip from 8 days later (E) is shown. Figure Legend: Copyright © American College of Physicians. All rights reserved.American College of Physicians

3 Date of download: 6/2/2016 From: Torsade de Pointes Associated with the Use of Intravenous Haloperidol Ann Intern Med. 1993;119(5):391-394. doi:10.7326/0003-4819-119-5-199309010-00007 Sequential tracings for patient 3 with corresponding QTc intervals.Values are expressed in milliseconds (ms). Standard lead II is shown in all tracings. All tracings were averaged at the time of measurement. The baseline strip (A) is shown, as are strips at 24 hours (B) and 48 hours (C) after the initiation of intravenous haloperidol. Note that T-U augmentation is seen in strip C and is important in determining Q-T intervals (see reference 3). A sample of the torsade de pointes (TdP) is shown in tracing D. The tracings gradually returned to baseline after discontinuation of haloperidol; a representative strip from 8 days later (E) is shown. Figure Legend: Copyright © American College of Physicians. All rights reserved.American College of Physicians

4 Date of download: 6/2/2016 From: Torsade de Pointes Associated with the Use of Intravenous Haloperidol Ann Intern Med. 1993;119(5):391-394. doi:10.7326/0003-4819-119-5-199309010-00007 Sequential tracings for patient 4 with corresponding QTc intervals.Values are expressed in milliseconds (ms). All tracings were averaged at the time of measurement. A baseline strip (A, standard lead II) shows the patient in atrial fibrillation. A sample of the torsade de pointes (TdP) is shown in tracing B, also standard lead II. Note the long-short initiating sequence leading to TdP (see reference 4). A tracing from 8 days later (with the patient in sinus rhythm) is shown in tracing C (standard lead II). Figure Legend: Copyright © American College of Physicians. All rights reserved.American College of Physicians


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