For which reason is baseline and periodic ECG monitoring important for patients on ziprasidone?

• A. Kidney impairment risk.
• B. QT interval prolongation risk.
• C. Visual field loss risk.
• D. Hair loss risk.

Answer: (B)

QT interval prolongation is the key safety concern with ziprasidone. This medication can slow the heart’s electrical repolarization, which lengthens the QT interval and can lead to dangerous rhythms such as torsades de pointes. Baseline ECG establishes what the QT interval looks like before starting treatment, and periodic ECGs track any changes after therapy begins. If the QTc is already prolonged or lengthens during treatment, clinicians can intervene—adjusting the dose, correcting electrolyte imbalances (like low potassium or magnesium), or stopping the drug—to reduce the risk of serious arrhythmias. While other issues like kidney problems, visual changes, or hair loss may be considerations in overall care, they are not the reason ECG monitoring is emphasized for ziprasidone.