Single intravenous dose ondansetron induces QT prolongation in adult emergency department patients: a prospective observational study
Dublin Core
Title
Single intravenous dose ondansetron induces QT prolongation in adult emergency department patients: a prospective observational study
Subject
Ondansetron, QT prolongation, Prediction, Emergency department
Description
Background Ondansetron is one of the most commonly used drugs in the emergency department (ED) for treating
nausea and vomiting, particularly in intravenous (IV) form. Nevertheless, it has been shown to prolong QT interval and
increase the risk of ventricular dysrhythmias. This study evaluated the associations between single IV ondansetron
dosage and subsequent QTc prolongation in the ED.
Methods In this prospective observational study, a total number of 106 patients presenting to the ED in a 3-month
period with nausea and vomiting treated with IV ondansetron were enrolled. QT and QTc intervals were measured at
baseline (QT0 and QTc0), and 60 min (QT60 and QTc60) following a single-dose administration of ondansetron at 4 or
8 mg doses. To evaluate the predictive ability of these variables, we employed receiver operating characteristic (ROC)
curve analyses.
Results The predictive models for QTc prolongation 1-hour post-ondansetron administration showed the following:
at baseline, the area under curve of 0.70 for QT, 0.71 for QTc, and 0.64 for dosage. Conversely, a QTc0=375 msec
indicated a QTc60>480 msec with a specificity of 97%. Additionally, a QTc0 of 400 msec had a sensitivity of 100%
in predicting a QTc60<480 msec, while a QTc0>460 msec predicted a QTc60>480 msec with a specificity of
98%. Moreover, 8 mg doses were associated with higher rates of QTc60 prolongation, while 4 mg doses favored
maintaining QTc60 within normal limits.
Conclusions Our study demonstrates the predictive capacity of QT0, QTc0, and ondansetron dosage in forecasting
QTc60 prolongation (>480 msec) post-ondansetron administration. These findings advocate for their incorporation
into clinical protocols to enhance safety monitoring in adult ED patients.
Keywords Ondansetron, QT prolongation, Prediction, Emergency department
nausea and vomiting, particularly in intravenous (IV) form. Nevertheless, it has been shown to prolong QT interval and
increase the risk of ventricular dysrhythmias. This study evaluated the associations between single IV ondansetron
dosage and subsequent QTc prolongation in the ED.
Methods In this prospective observational study, a total number of 106 patients presenting to the ED in a 3-month
period with nausea and vomiting treated with IV ondansetron were enrolled. QT and QTc intervals were measured at
baseline (QT0 and QTc0), and 60 min (QT60 and QTc60) following a single-dose administration of ondansetron at 4 or
8 mg doses. To evaluate the predictive ability of these variables, we employed receiver operating characteristic (ROC)
curve analyses.
Results The predictive models for QTc prolongation 1-hour post-ondansetron administration showed the following:
at baseline, the area under curve of 0.70 for QT, 0.71 for QTc, and 0.64 for dosage. Conversely, a QTc0=375 msec
indicated a QTc60>480 msec with a specificity of 97%. Additionally, a QTc0 of 400 msec had a sensitivity of 100%
in predicting a QTc60<480 msec, while a QTc0>460 msec predicted a QTc60>480 msec with a specificity of
98%. Moreover, 8 mg doses were associated with higher rates of QTc60 prolongation, while 4 mg doses favored
maintaining QTc60 within normal limits.
Conclusions Our study demonstrates the predictive capacity of QT0, QTc0, and ondansetron dosage in forecasting
QTc60 prolongation (>480 msec) post-ondansetron administration. These findings advocate for their incorporation
into clinical protocols to enhance safety monitoring in adult ED patients.
Keywords Ondansetron, QT prolongation, Prediction, Emergency department
Creator
Mohammad Rezaei Zadeh Rukerd1
, Fatemeh Rafiei Shahrbabaki2
, Mitra Movahedi2
, Amin Honarmand2
,
Pouria Pourzand2* and Amirhossein Mirafzal2*
, Fatemeh Rafiei Shahrbabaki2
, Mitra Movahedi2
, Amin Honarmand2
,
Pouria Pourzand2* and Amirhossein Mirafzal2*
Source
https://doi.org/10.1186/s12245-024-00621-5
Date
2024
Contributor
Peri Irawan
Format
pdf
Language
english
Type
text
Files
Collection
Citation
Mohammad Rezaei Zadeh Rukerd1
, Fatemeh Rafiei Shahrbabaki2
, Mitra Movahedi2
, Amin Honarmand2
,
Pouria Pourzand2* and Amirhossein Mirafzal2*, “Single intravenous dose ondansetron induces QT prolongation in adult emergency department patients: a prospective observational study,” Repository Horizon University Indonesia, accessed April 11, 2026, https://repository.horizon.ac.id/items/show/12323.