Mechanisms of drug-induced proarrhythmia in clinical practice

Table 1 Drugs implicated in acquired long QT syndrome

Category	Drugs
Antianginal	Bepridil
Antiarrhythmic	Disopyramide, procainamide, quinidine, mexiletine, propafenone, flecainide, d,l-sotalol, amiodarone, dronedarone, bretylium, dofetilide, ibutilide, azimilide, ajmaline
Anticancer	Tamoxifen, lapatinib, vandetanib, nilotinib, arsenic trioxide
Antifungal	Itraconazole, ketoconazole, fluconazole, voriconazole
Antimicrobial	Erythromycin, clarithromycin, azithromycin, spiramycin, telithromycin, levofloxacin, moxifloxacin, sparfloxacin, gatifloxacin, grepafloxacin, gemifloxacin, ofloxacin, trimethoprim-sulfamethoxazole, pentamidine, quinine, chloroquine, mefloquine, halofantrine
Antiviral	Foscarnet
Antihistamine	Astemizole, diphenhydramine, ebastine, terfenadine, hydroxyzine
Antidepressant	Doxepin, venlafaxine, fluoxetine, desipramine, imipramine, clomipramine, paroxetine, sertraline, citalopram, escitalopram
Antipsychotic	Chlorpromazine, prochlorperazine, trifluoperazine, fluphenazine, felbamate, haloperidol, thioridazine, droperidol, mesoridazine, pimozide, risperidone, quetiapine, ziprasidone, lithium, chloral hydrate, pericycline, sertindole, sultopride, zimeldine, maprotiline, tiapride
Antimigraine	Naratriptan, sumatriptan, zolmitriptan
Bronchodilators	Albuterol, salmeterol
Diuretics	Indapamide, thiazide, furosemide
Gastrointestinal stimulants	Cisapride, metoclopramide, domperidone
Hormones	Octreotide, vasopressin
Immunosuppressives	Tacrolimus
Others	Probucol, methadone, cocaine, amantadine, aconitine, veratridine, vincamine, terodiline, budipine, tizanidine, organophosphorus compounds

The full list can be accessed via the internet (http://www.torsades.org, http://www.qtdrugs.org, http://www.longqt.org, http://www.sads.org).

Table 2 Agents implicated in drug-induced Brugada electrocardiographic pattern

Category	Drugs
Antiarrhythmic	Ajmaline, flecainide, pilsicainide, procainamide, propafenone
Antidepressant	Amitriptyline, nortriptyline, clomipramine, desipramine, imipramine, doxepin, dosulepine, maprotiline, lithium, fluoxetine, paroxetine, fluvoxamine,
Antipsychotic	Loxapine, trifluoperazine, cyamemazine, perphenazine, thioridazine
Anti-epileptic	Oxcarbazepine
Anesthetics/analgesics	Bupivacaine, propofol
Antihistamines	Diphenhydramine, dimenhydrinate
Other substances	Cocaine, alcohol, metoclopramide, acetylcholine, ergonovine maleate, edrophonium

The full list can be accessed via the internet (http://www.brugadadrugs.org).