A 70-year-old woman on ciprofloxacin for a UTI develops QTc prolongation to 510 ms (baseline was 440 ms). She has hypokalaemia (K⁺ 3.2 mmol/L) from

Question

A 70-year-old woman on ciprofloxacin for a UTI develops QTc prolongation to 510 ms (baseline was 440 ms). She has hypokalaemia (K⁺ 3.2 mmol/L) from vomiting. She is haemodynamically stable with no arrhythmias. What is the most appropriate management?

Accepted Answer

Cease sotalol and switch to an alternative

Answer

Continue sotalol and add mexiletine

Answer

Reduce sotalol dose by 50%

Answer

Continue sotalol unchanged

Answer

Add IV magnesium and continue sotalol

Fluoroquinolone QT Prolongation — RACP Adult Medicine MCQ

A 70-year-old woman on ciprofloxacin for a UTI develops QTc prolongation to 510 ms (baseline was 440 ms). She has hypokalaemia (K⁺ 3.2 mmol/L) from vomiting. She is haemodynamically stable with no arrhythmias. What is the most appropriate management?