For hospitalized patients on chronic methadone, these new guidelines help aid us in decision making, based on the patient’s QT interval (guidelines). Of the highlights, they recommend if the QT is >500 ms, we should consider reducing or discontinuing the methadone (the QT prolonging effect is dose-dependent), and discontinuing any medications that promote hypokalemia. They also recommend vigilence in starting new drugs with QT prolonging potential (website list)
Dr. Scheurer is a clinical hospitalist and the Medical Director of Quality and Safety at the Medical University of South Carolina in Charleston, South Carolina, and is Assistant Professor of Medicine. She is a graduate of the University of Tennessee College of Medicine, completed her residency at Duke University, and completed her Masters in Clinical Research at the Medical University of South Carolina. She also serves as the Web Editor and Physician Advisor for the Society of Hospital Medicine.