Sudden death from medication


Fatal cardiac arrhythmias due to drug side effects

The term "cardiac arrest" describes the sudden occurrence of fatal cardiac arrhythmias, often in people who, according to their own and other people's perceptions, were actually healthy. The second heart death is not always an unpredictable fate. It can also be the result of the side effect of so-called "QT-interval prolonging" drugs (QT-IVAM), which can trigger such rhythm disturbances. The simultaneous prescription of several QT-IVAM is particularly dangerous and therefore usually not indicated.

Simultaneous treatment of a patient with multiple drugs that prolong the so-called "QT interval" on the ECG can increase the risk of sudden cardiac death. The side effects are not recognized in many cases - because the medicines that cannot be combined are often prescribed by different doctors. Current risk warnings from the German, European and American regulatory authorities indicate that patients taking medicinal products containing the active substances citalopram or escitalopram should avoid a combination with other medicinal products that prolong the QT interval. Both drugs are often prescribed for depression.

From the number of daily doses of citalopram and escitalopram prescribed in Germany of more than 200 million (Drug Ordinance Report 2011), it can be concluded that up to 1.8 million people across Germany are treated with these active ingredients and could be at risk.

This is where the nationwide unique project of the IKK Südwest and its cooperation partners comes in. It has several unique international features and has been awarded the Health Innovation Prize by the Financial Times Deutschland.

With the help of a specially developed software from the company RpDoc Solutions, patients are identified on the basis of the drug prescription data who are given several QT-IV drugs at the same time and thus have a potentially avoidable risk of sudden cardiac death. "The RpDoc Risk Radar Drug Therapy identifies avoidable, prescription-related risks that the individual doctor cannot recognize or can only recognize with difficulty," said Simone Grandt, managing director of the company.

If the patient concerned gives his consent, the doctors treating him will be informed about the overall medication and the identified risks. This enables the doctor to use alternative drug therapies if necessary. The assessment of the potential risks and the subsequent information of the insured and doctors is carried out in close coordination with the Association of Statutory Health Insurance Physicians (KV) Saarland. "KV Saarland sees the program as a practical model that enables the doctor to identify and avoid risks for the patient," says Dr. Gunter Hauptmann, Chairman of the Board of Directors of KV Saarland.

"With this project, which is unique in the world, Saarland wants to give an impetus to continue on this path and to significantly increase drug therapy safety for patients, especially when it comes to avoidable risks. The project was launched at the beginning of June 2012 at the e-Health Conference in Saarbrücken presented and has been continuously developed since then, "says Saarland Minister of Health Andreas Storm as patron of the joint project.

"As an innovative health insurer, we feel obliged to protect our insured parties as effectively as possible from dangerous drug interactions. We are therefore proud of our pioneering role in the fight against sudden cardiac death," explains Frank Spaniol, CEO of IKK Südwest. From the very beginning, the project partners worked closely with the Federal Institute for Drugs and Medical Devices (BfArM), which, like the Saarland Ministry of Health, also supported the project financially. (pm)

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Sudden cardiac death without warning
Sudden cardiac death depending on the time of day

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