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CARDIAC DRUG THERAPY - PART 2

Tại Hoa Kỳ, thuốc này được chấp thuận cho sử dụng đường uống ở bệnh nhân loạn nhịp thất đe dọa tính mạng (duy trì VT). Đại lý này không được khuyến cáo để điều trị nhịp tâm thất không có triệu chứng sớm. | 30 Cardiac Drug Therapy Drug name Sotalol Trade names Sotacor Betapace Beta-Cardone Supplied 80 160 240 mg Dosage 40-80 mg once daily increase over days to weeks to 80-160 mg once or twice daily Indications In the United States this drug is approved for oral use in patients with life-threatening ventricular arrhythmias sustained VT . This agent is not recommended for the treatment of asymptomatic ventricular premature beats. In the United Kingdom and Canada the drug is indicated for hypertension and for the management of arrhythmias including paroxysmal atrial fibrillation or for the maintenance of sinus rhythm in place of quinidine 80 . The response to sotalol predicts the response to amiodarone during serial drug testing in patients with sustained VT. Sotalol is unique among the approved beta-blockers. The drug has all the effects of a nonselective beta-blocker plus an added class III antiarrhythmic effect the drug lengthens the duration of the cardiac action potential and prolongs the QTc interval of the surface electrocardiogram. The drug appears to be more effective than other beta-blockers in the control of numerous bothersome ventricular premature beats and sustained VT. However some studies indicate no difference in efficacy. The drug has been shown to cause an 88 reduction in ventricular ectopic beat frequency at the optimal titrated dosage. Torsades de pointes have been precipitated as a rare complication mainly in patients with hypokalemia. Torsades occurred however despite therapeutic plasma sotalol concentration and normal serum potassium level in the absence of diuretics. Caution is necessary do not administer sotalol with nonpotassium-sparing diuretics and drugs that cause QT prolongation. The drug represents a significant advance in the management of some ventricular tachyarrhythmias including recurrent VT tachycardia or VF. Contraindications Congenital or acquired long QT syndromes are contraindications as well as other contraindications to .