Psych Vivas · Psychopharmacology — drug interactions and QTc
Drug interactions and QTc — consultant viva
Fellowship viva on interaction taxonomy, CYP maps, QTc measurement, risk stratification, TdP, and polypharmacy safety.
On this page
Study tools
Target exams
FRANZCPMRCPsychABPNMD-DNB
Prompt
Examiner cards: PK vs PD; CYP1A2 smoking/clozapine; fluvoxamine; Bazett vs Fridericia; QTc 510 ms; TdP magnesium; Ray 2009; methadone + antipsychotic; citalopram dose cap; Tisdale factors.
Station structure
Time: 8–10 minutes. Depth: consultant teaching registrar. Expect named trials, CYP enzyme precision, and action thresholds stated as teaching bands rather than invented universal statutes.[1][5]
References10ShowHide
- [1]Roden DM Drug-induced prolongation of the QT interval N Engl J Med, 2004.PMID 14999113
- [2]Ray WA, Chung CP, Murray KT, et al. Atypical antipsychotic drugs and the risk of sudden cardiac death N Engl J Med, 2009.PMID 19144938
- [3]Rostami-Hodjegan A, Amin AM, Spencer EP, et al. Influence of dose, cigarette smoking, age, sex, and metabolic activity on plasma clozapine concentrations: a predictive model and nomograms to aid clozapine dose adjustment and to assess compliance in individual patients J Clin Psychopharmacol, 2004.PMID 14709950
- [4]Hiemke C, Weigmann H, Härtter S, et al. Elevated levels of clozapine in serum after addition of fluvoxamine J Clin Psychopharmacol, 1994.PMID 7962687
- [5]Beach SR, Celano CM, Noseworthy PA, et al. QTc prolongation, torsades de pointes, and psychotropic medications Psychosomatics, 2013.PMID 23295003
- [6]Drew BJ, Ackerman MJ, Funk M, et al. Prevention of torsade de pointes in hospital settings: a scientific statement from the American Heart Association and the American College of Cardiology Foundation Circulation, 2010.PMID 20142454
- [7]Vandenberk B, Vandael E, Robyns T, et al. Which QT Correction Formulae to Use for QT Monitoring? J Am Heart Assoc, 2016.PMID 27317349
- [8]Krantz MJ, Martin J, Stimmel B, et al. QTc interval screening in methadone treatment Ann Intern Med, 2009.PMID 19153406
- [9]Castro VM, Clements CC, Murphy SN, et al. QT interval and antidepressant use: a cross sectional study of electronic health records BMJ, 2013.PMID 23360890
- [10]Tisdale JE, Jaynes HA, Kingery JR, et al. Development and validation of a risk score to predict QT interval prolongation in hospitalized patients Crit Care Med, 2013.PMID 23716032