The Risk of QTc Prolongation with Antiemetics in the Palliative Care Setting: A Narrative Review

J Pain Palliat Care Pharmacother. 2021 Jun;35(2):125-135. doi: 10.1080/15360288.2021.1900491. Epub 2021 May 11.

Abstract

Nausea and vomiting are common within the palliative care population. Antiemetic agents may help control symptoms, but may also place patients at risk for QTc prolongation. This article reviews pharmacotherapy agents including anticholinergics, antihistamines, antidopaminergics, 5-HT3 receptor antagonists, dronabinol, and medical marijuana and their associated risk of QTc prolongation. A clinical treatment pathway is provided to help guide clinicians in choosing the most appropriate antiemetic based upon patient specific factors for QTc prolongation.

Keywords: Palliative care; QTc prolongation; antiemetics; nausea and vomiting.

Publication types

  • Review

MeSH terms

  • Antiemetics* / therapeutic use
  • Antineoplastic Agents* / therapeutic use
  • Humans
  • Long QT Syndrome* / chemically induced
  • Nausea / chemically induced
  • Nausea / drug therapy
  • Nausea / prevention & control
  • Palliative Care
  • Vomiting / drug therapy

Substances

  • Antiemetics
  • Antineoplastic Agents