sotalol
Table of Contents
sotalol
see also beta blockers
Summary:
- A non-cardioselective beta-adrenergic antagonist devoid of intrinsic sympathomimetic & membrane-stabilizing actions. But unlike other b-blockers, it prolongs action potential duration recorded in cardiac tissue, increases the refractory period & lengthens QT interval.
- It has less neg. inotrope activity than other b-blockers as it tends to increase contractility by prolongation of action potentials - but may aggravate CCF in some pts.
- It is an effective antiarrhythmic agent & antifibrillatory agent.
- It can cause torsade de pointes & thus although relatively safe after AMI, would not be recommended routinely as a substitute for other b-blockers;
Use in SVTs and AF:
- IV bolus terminated 33% acute atrial flutter & 20% of AF;
- Efficacy increased with continuous infusion;
- ? as effective as digoxin + disopyramide Rx for post-op AF/flutter;
- Oral Rx significantly reduced incidence of AF/flutter post-CABG BUT pro-arrhythmia effects outweigh its benefits.
- ? Better than quinidine in maintaining sinus rhythm after DC cardioversion of AF BUT pro-arrhythmia effects outweigh its benefits.
Use in unsustained symptomatic complex ventricular activity:
- As effective as quinidine & better than propranolol or procainamide.
- this use not recommended at present
Use in sustained ventricular arrhythmias:
- see VT
- Better than procainamide in preventing VT/VF recurrence;
- this use not recommended at present
P/K:
- readily absorbed orally with near 100% bioavailability → peak [] 2-3hrs;
- Renally excreted unchanged; T1/2 = 10-15hrs; Not metabolised; Not bound to plasma proteins;
Adverse Effects of sotalol:
- as for beta blockers;
- proarrhythmic 2.5%;
- heart failure 1%;
- bradycardia 3%;
- torsade de pointes 2% pts Rx for malig. vent.arrhythmias- esp. 1st wk with incr. QTc
Drug Interactions of sotalol:
- as for beta blockers but also any drug that causes prolonged QT interval should be avoided.
sotalol.txt · Last modified: 2009/02/24 10:06 by 127.0.0.1