QRS prolongation

PR prolongation QT prolongation QRS prolongation Increased anticholinergic and no-radernergic tone at the His bundle, leading to blockade of electrical impulses Bradycardia Palpitations Fainting Sudden death Monitor EKG parameters frequently Wilens et al., 1996... 

A 35-year-old woman took diphenhydramine 16 g and developed hypertension and QRS prolongation charcoal hemoperfusion and hemodialysis were used successfully (12). 

Figure 12.2 Electrocardiograms from a horse undergoing treatment for atrial fibrillation, (a, b) Base-apex (a) and modified base-apex (b) electrocardiograms after treatment with quinidine sulfate (330mg/kg). Ventricular tachycardia, (torsades de pointes) occurred after 40 h. (c) The horse was treated with five bolus doses of magnesium sulfate, together with intravenous propanoloi, which resulted in conversion to normal sinus rhythm with QRS prolongation, (d) Twenty-four hours after conversion, the electrocardiogram showed normal sinus rhythm without QRS prolongation.

Procainamide does not produce serious side-effects like quinidine and lidocaine (lignocaine) however, it is a negative inotrope and may cause hypotension QRS prolongation and ventricular arrhythmias can occur at high doses (Muir Mcguirk 1987). 

Monitor ECG for cardiac changes, particularly widening of QRS, prolongation of PR and QT interval. Notify provider of significant interval changes. 

QRS prolongation, if progressive Intravenous sodium bicarbonate to a blood pH of 7.5 even in the... 

Sandhu R, Bahler RC. Prevalence of QRS prolongation in a community hospital cohort of patients with heart failure and its relation to left ventricular systolic dysfunction. Am J Cardiol 2004 93(2) 244-6. 

Tricyclic antidepressants Antimuscarinic effects (see above). The three C s" of coma, convulsions, cardiac toxicity (QRS prolongation, arrhythmias, hypotension) Control seizures. Correct acidosis and cardiotoxicity with ventilation and bicarbonate. Control hyperthermia... 

B. Specific drugs and antidotes. In patients with Intoxication by type la or type Ic drugs, QRS prolongation, bradyarrhythmias, and hypotension may respond to sodium bicarbonate, 1-2 mEq/kg IV (see p 419). The sodium bicarbonate reverses cardiac-depressant effects caused by inhibition of the fast sodium channel. 

Lamotrigine 22-36 h 200-500 mg Lethargy, dizziness, ataxia, stupor, nystagmus, hypertonia, seizures QRS prolongation nausea and vomiting hypokalemia hypersensitivity fever, rash (Stevens-Johnson syndrome) hepatitis, renal failure. 

B. Severe intoxication may cause coma, seizures, and respiratory arrest. The ECG may show QTc interval prolongation and occasionally QRS prolongation (particularly with thioridazine [Mellaril]). Hypothennia or hyperthennia may occur. Clozapine can cause a prolong confusional state and rarely cardiac toxicity. 

Love JN, Elshami J Cardiovascular depression resulting Irom atenolol intoxication. EurJ Emerg Med 2002 9(2) 111-114. [PMID 12131631] (A patient with massive atenolol ingestion developed hypotension in association with QRS prolongation the authors point out that although rare, even hydrophilic agents can produce membrane-depressant etiects that are more commonly seen with lipophilic drugs like propranolol.)... 

Marquardt K, Albertson T Treatment ot hydroxychloroquine overdose. Am J Emerg Med 2001 19(5) 420-424. [PMID 11555803] (Case report demonstrating hypotension, QRS prolongation, and hypokalemia the authors provide a review ot the literature and summary of recommended treatment.)... 

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