QTc prolongation in cannabis hyperemesis syndrome patients exposed to antiemetics: A retrospective chart review

Abstract

Objective: To evaluate the risk of QT prolongation in patients treated for Cannabis Hyperemesis Syndrome (CHS) in the emergency department.

Methods: This was a retrospective comprehensive chart review of patients in the University of Colorado Health Emergency Department. Charts were identified by ICD9/10 codes from January 1, 2012 to December 31, 2014 for cannabis use and data were manually abstracted. We performed chi-square and odds ratios, stratified by drug, to determine differences in medication induced QTc prolongation and performed logistic regression to predict prolongation greater than 500 ms. We captured adverse events from medications as a secondary outcome.

Results: We found 282 cases of CHS during the study period. There were no significant differences between the median post-medication QTc value stratified by drug when all medications were analyzed simultaneously. A multiple logistic regression model showed that only a potassium below 3.0 mmol/L predicted QT prolongation greater than 500 msec.

Conclusion: Anti-emetics used to treat CHS did not result in significant QTC prolongation in this cohort.

Keywords: Antiemetic.; Cannabis.; Hyperemesis.; Marijuana; QTc.