Which safety concern requires monitoring when using bedaquiline or delamanid?

• A. Nephrotoxicity
• B. Visual impairment
• C. QT interval prolongation
• D. Hyperglycemia

Answer: (C)

The main idea is that bedaquiline and delamanid can prolong the heart’s repolarization, shown as QT interval prolongation on an ECG. Because this effect can trigger dangerous arrhythmias like torsades de pointes, the safety plan centers on cardiac monitoring rather than kidney function or vision.

Before starting treatment, obtain a baseline ECG and check electrolytes (potassium, magnesium, calcium). During therapy, repeat ECGs periodically and whenever changing other medications. Correct any electrolyte abnormalities, and avoid combining these drugs with other medicines that also extend the QT interval. If the QTc becomes too long (a threshold often around 500 ms or a large rise from baseline), consider adjusting or stopping therapy to prevent serious rhythm problems.

Other safety concerns such as nephrotoxicity, visual impairment, or hyperglycemia are not the primary monitoring focus for these drugs, so they aren’t the key safety checks in this context.