• Pamela L Smithburger, Amy L Seybert, Michael J Armahizer, and Sandra L Kane-Gill.
• University of Pittsburgh School of Pharmacy, Critical Care Pharmacist, Medical Intensive Care Unit, University of Pittsburgh Medical Center, 200 Lothrop Street, PFG 01-01-01, Pittsburgh, PA 15213, USA. smithburgerpl@upmc.edu
• Expert Opin Drug Saf. 2010 Sep 1;9(5):699-712.

Importance Of The FieldCritically ill patients are at an increased risk to develop drug-drug interactions (DDIs). DDIs that increase the risk of QT prolongation, and ultimately torsades de pointes, can result in a medical emergency. Many clinicians are unaware of the risk of certain drug combinations that may precipitate QT prolongation in the intensive care unit (ICU). Additional DDI education and a review of management strategies could assist with prevention of future adverse outcomes.Areas Covered In This ReviewThis review focuses on some commonly used medications in the ICU that may be involved in pharmacokinetic and/or pharmacodynamic DDIs leading to the development of QT prolongation and possibly torsades de pointes. Also, appropriate management strategies are discussed.What The Reader Will GainThe ICU clinician will gain a better understanding of common medications used in the ICU and DDIs that put patients at risk for the development of QT prolongation and torsades de pointes.Take Home MessageMedications that may cause QT prolongation are common in the ICU and DDIs need to be identified and prevented by the clinician to avoid a potentially life-threatening dysrrhythmia.

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