Prolonged Q-T Syndrome
Counteractive Measures to prevent or stop a Torsades attack:
In a situation where certain drugs cannot be avoided, Imdur is a nitrate in extended release pill form which can help counteract the deadly effects of these medicines on a Torsades patient. Keep in mind that Imdur is only an 8 hour medication and the protective benefit will not protect the patient beyond that time period so additional doses may be needed. Keep in mind, however, a prolonged use of nitro on a 24 hour basis will significantly reduce the drugs ability to benefit the patient. So if the Torsades reactive medicine is needed on a long term basis with no alternative drugs available, you may want to limit the Imdur doses to once or twice a day (8-16 hours of protection, some of which may have enough residual benefits to stretch over a longer period of time.. such as 1 every 12 hours... but that is just a guess on my part and would need to be evaluated by a licensed physician). In my case, I have been taking 1 Imdur each day for the past 10 years, occasionally 2 per day under certain circumstances or when taking multiple daily dose medications on a temporary basis. I still keep the sublingual nitro spray handy in the event I need it. I recommend sublingual spray over nitro pills because the spray lasts for years while the pills deteriorate in 6 months and cannot be subjected to heat, moisture or sunlight. A nitro patch may also work, but I have not tried it except during surgical procedures. Sublingual nitro spray can stop a Torsades attack, but only if it is administered prior to the onset of fibrillation. Once fibrillation begins, nitro has no effect. The nitro sprays or tablets will only provide a very short term protection. Also keep in mind that although this method does work on me, it may not be as effective on someone else.
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