Torsades De Pointes Ventricular Tachycardia

-Correct underlying cause and consider discontinuing quinidine, procain-amide, disopyramide, moricizine, lidocaine, amiodarone, sotalol, cisapride, Ibutilide, phenothiazine, haloperidol, tricyclic and tetracyclic antidepressants, ketoconazole, itraconazole, bepridil, hypokalemia, and hypomagnesemia.

-Magnesium sulfate 1-4 gm in IV bolus over 5-15 min or infuse 3-20 mg/min for 7-48h until QT interval <440 msec.

-Isoproterenol (Isuprel), 2-20 mcg/min (2 mg in 500 mL D5W, 4 mcg/mL).

-Consider ventricular pacing and/or cardioversion.

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