Turkey’s pharmaceutical institution has published a list of drugs that cause QT prolongation in ECG, called cardiac electrocardiogram. It’s not on the list. I expected that this list would be an opportunity for rational drug use, especially in our country where antibiotics are used too much and microbial resistance is high. Unfortunately, the expected mountain gave birth to mice. That’s why there has been a need to say that the job has come to an end and to inform the public.
Unfortunately, our country is one of the three countries in the world where medicine is available without a prescription. It is the only country where the obligation to prescribe over-the-counter medicine after use is imposed on physicians by neighborhood pressure. As such, physicians; It is tried to be reduced to the secretariat of drug cartels and pharmacies. So much so that companies that carry out drug promotion activities have shifted their weight to pharmacies. With a new freak approach under the name of the patient’s ease of access to drugs; The drug-representative-pharmacy relationship is persistently ignored by the political authority. As a result of this “populist” approach, the masses, unaware of what “Physician Responsibility Awareness” means, have attempted to play doctor.
Medication side effects; Although it is a phenomenon that has existed for a long time and is frequently recurring, unfortunately it has been normalized by the society accustomed to utilitarianism in our imaginary perceptions. As a result of these careless practices in the approach to medicine; Neither drug side effect information was recorded nor detailed investigation studies could be conducted in patients with combined drug administrations. A rather fluffy number of superstitions that cannot go beyond rumors; Despite the existence of evidence-based medicine stuffed into the folds of the people’s cognitive pool, scientific hierarchy has been tried to be suppressed. In a society where everyone is a doctor, it is far from possible to achieve another outcome.
Let’s get to the QT issue! QT prolongation on EKG; It can be seen in genetic disorder, electrolyte imbalance, and in cases of unknown cause, as well as occur as side effects of some drugs. QT prolongation, which can cause syncope; It also causes sudden cardiac death. QT prolongation impairs the blood pumping capacity of the heart in the long term and paves the way for heart failure.
Although QT prolongation due to genetic and unknown conditions is not very common, QT prolongation due to electrolyte disorders and drug use is not uncommon.
Almost half of the antibiotic groups easily available without consulting a doctor (Erythromycin, clarithromycin, clindamycin, trimethoprim-sulfamethoxazole, almost all of the quinolone groups, fluconazole, ketoconazole), almost all of the antipsychotic drugs that have recently been widely used in sleep disorders ( Chlorpromazine, haloperidol, droperidol, pimozide, thioridazine, sertindo, risperidone, ziprasidone, quetiapine) and the majority of antidepressant drugs (Desimipramine, nortriptyline, amitriptyline, doxepin, fluoxetine, pimozide, imipramine, sertraline) cause QT prolongation.
The effects of these drugs on QT; It is not an occasional side effect. The drugs in question cause QT prolongation in almost every patient’s ECG, albeit to some extent.
Even worse, the drugs in question are in many patients; It is the use of polypharmacy, that is, the use of multiple drugs, as if mocking the “rational drug use” motto.
That’s why every patient should now carry an EKG in their pocket as if they were carrying a “head sheet”. Anyone who comes before him, including pharmacists, should stop playing doctor.
Otherwise, “antibiotic kills too!”
