Anti-Nausea Medications for Cannabis Hyperemesis Did Not Cause Dangerous Heart Rhythm Changes

No significant differences in post-medication QTc values were found between different anti-emetic drugs used to treat CHS. The only predictor of QTc prolongation above 500 ms was potassium below 3.0 mmol/L.

Retrospective chart review of 282 CHS cases at the University of Colorado Health Emergency Department from January 2012 to December 2014. Identified by ICD9/10 codes for cannabis use. Chi-square tests, odds ratios, and logistic regression were used to analyze QTc prolongation by medication.

CHS patients often receive multiple anti-emetic medications, some of which are known to prolong the QTc interval. This study provides reassurance that these medications are relatively safe from a cardiac standpoint in CHS patients, as long as electrolytes are monitored.

CHS has become increasingly common, and emergency physicians need to know that standard anti-emetic treatments are cardiac-safe for these patients. The potassium finding makes clinical sense because CHS patients often have electrolyte depletion from persistent vomiting.

Retrospective design with cases identified by billing codes, which may miss or misclassify some cases. The study period (2012-2014) predates some newer CHS treatment approaches. Sample size may be insufficient to detect rare cardiac events.