T waves flattened

The bradycardia-tachycardia ("sick sinus") syndrome is a definite contraindication to the use of lithium because the ion further depresses the sinus node. T-wave flattening is often observed on the ECG but is of questionable significance. 

Electrocardiographic ST depression, T wave flattening and inversion, U waves and a prolonged Q-T interval are common but transient occurrences after acute ischemic, and particularly after acute hemorrhagic, stroke. They seldom cause clinical problems. Some abnormalities may have preceded the stroke (Oppenheimer et al. 1990). It is not known... 

Lithium may cause cardiac effects including T-wave flattening or inversion (up to 30% of patients), atrioventricular block, and bradycardia. If a patient has preexisting cardiac disease, a cardiologist should be consulted and an electrocardiogram obtained at baseline and regularly during therapy. 

Electrocardiographic changes, such as prolongation of the QT interval, widening of the QRS complex, and T wave flattening, can be seen with plasma concentrations above 15 pg/ml (SEDA-11, 590) (SEDA-14, 239). 

Typical symptoms of lithium intoxication are summarized in Table 2 [122-127]. The clinical picture of hthium intoxication is dominated by neuromuscular and cerebral symptoms in mild cases apathy, muscle weakness, tremor, and unsteady gait are seen. In more severe cases speech disturbances, myoclonic twitching, coma and convulsion can occur. Pulse irregularities and circulatory collapse may supervene. Lithium often causes T-wave flattening or inversion on the electrocardiogram, but clinically important cardiovascular effects are rare, with sinus-node dysfunction reported most often [123]. Residual neurological sequelae consisting of cerebellar dysfunction with ataxia, neuropathy and supra-bulbar symptoms are not unusual. 

Low potency agents sedation, anticholinergic effects, orthostasis, ECG changes (QT prolongation, T-wave flattening, QRS widening). 

I T-wave flattening/inversion in 30% of patients. I Hypothyroidism and nontoxic goitre (5%). 

Muscle pain and joint stiffness nausea transaminase elevations T-wave flattening or inversion weakness colic liver damage bradycardia leukopenia diarrhea rash pruritus myocardial damage hemolytic anemia renal damage shock sudden death Suramin Sodium... 

A 57-year-old woman was given two doses of oral sodium phosphate solution over two consecutive nights before colonoscopy, after completion of which she complained of numbness and tingling in her lips, hands, and feet [87 ]. She had hypokalemia, and an electrocardiogram showed T-wave flattening and U waves. She was found to have primary hyperaldosteronism and underwent adreiisdectomy 6 months later. 

Other cardiovascular effects that may be induced by lithium include bradycardia and atrioventricular block. Changes on EKG including T-wave flattening are common. These effects are usually benign and reversible, but lithium s use in patients with significant cardiovascular disease should be with caution. 

ECG changes include increased heart rate, flattened T waves, ST-segment depression, prolongation of QT and PR intervals, and torsade de pointes. Torsade de pointes has been reported with thioridazine, which may be a cause of cardiac sudden death. 

Cardiovascular manifestations include hypertension and cardiac arrhythmias (e.g., heart block, atrial flutter, paroxysmal atrial tachycardia, ventricular fibrillation, and digitalis-induced arrhythmias). In severe hypokalemia (serum concentration <2.5 mEq/L), ECG effects include ST-segment depression or flattening, T-wave inversion, and U-wave elevation. 

ECG changes include widened QRS complexes and peaked T waves in mild deficiency. Prolonged PR intervals, progressive widening of the QRS complexes, and flattening of T waves occur in moderate to severe deficiency. 

ECG changes - A minority of clozapine patients experience ECG repolarization changes similar to those seen with other antipsychotic drugs, including S-T segment depression and flattening or inversion of T waves, which all normalize after discontinuation of clozapine. 

WARNING Long-acting p2-agonists may t risk of asthma-related death Uses COPD maint Action LA p2-agonist, relaxes airway smooth muscles Dose 15 meg neb bid, 30 meg/d max Caution [C, ] w/ CV Dz, X Contra Not for acute asthma component hyp sensitivity peds w/ phenothiazines Disp Meg neb SE Chest/back pain, D, sinusitis, leg cramps, dyspnea, rash, flu-synd, t BP, arrhythmias, heart block J-K EMS Monitor ECG for arrhythmias, heart block, and hypokalemia (flattened T waves) t risk of acute asthma attack, treat w/ shortacting p-agonist OD May cause CP, palpitations, muscle tremors and cramps, and syncope symptomatic and supportive... 

WARNING Renal impair is the major tox foUow administration instructions Uses CMV retinitis w/ HIV Action Selective inhibition of viral DNA synth Dose Rx 5 mg/kg IV over 1 h once/wk for 2 wk w/ probenecid Maint 5 mg/kg IV once/2 wk w/ probenecid (2 g PO 3 h prior to cidofovir, then 1 g PO at 2 h 8 h after cidofovir) X in renal impair Caution [C, -] Contra Probenecid or sulfa allergy Disp Inj SE Renal tox, chills, fever, HA, NA /D, thrombocytopenia, neutropenia Interactions t Nephrotox W/ aminoglycosides, amphot icin B, foscar-net, IV pentamidine, NSAIDs, vancomycin t effects W/zidovudine EMS Monitor ECG for hypocalcemia (t QT int val) and hypokalemia (flattened T waves) OD May cause renal failure hydration may be effective in reducing drug levels/effects Cilostazol (Pletal) TAntiplatelet, Arterial Vasodilator/ Phosphodiesterase Inhibitor] Uses Reduce Sxs of intermittent claudication Action Phosphodiesterase in inhibitor t s cAMP in pits blood vessels, vasodilation inhibit pit aggregation Dose 100 mg PO bid, 1/2 h before or 2 h after breakfast dinner Caution [C, +/-] Contra CHE, hemostatic disorders. 

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