Sotalol: Difference between revisions
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==General== | ==General== | ||
*Type: [[Beta blockers]] | *Type: [[Beta blockers]] | ||
*Dosage Forms: | *Dosage Forms: Tab (80 mg, 120 mg, 160 mg, 240 mg); Injection | ||
*Common Trade Names: | *Common Trade Names: Sotalol | ||
==Adult Dosing== | ==Adult Dosing== | ||
*80mg PO | ===Ventricular arrhythmia, life-threatening=== | ||
*80-160 mg PO q12h | |||
**Start: 80mg PO q 12h | |||
**Max: 640 mg/day | |||
**Taper over 1-2wk to D/C | |||
*75-150 mg IV q12h | |||
**Start: 75 mg IV q12h | |||
**Max: 600 mg/day | |||
**Taper over 1-2wk to D/C | |||
==Pediatric Dosing== | ==Pediatric Dosing== | ||
===Ventricular arrhythmia, life-threatening=== | |||
*<2 yo | |||
**Dose based on [[BSA]] and age-specific factor | |||
*2+ yo, PO | |||
**90-180 mg/m^2/day PO divided TID | |||
***Start: 90mg/m^2/day | |||
***Max: 180mg/m^2/day | |||
*2+ yo, IV | |||
**84-168mg/m^2/day IV divided TID | |||
***Start: 84mg/m^2/day | |||
***Max: 168mg/m^2/day | |||
==Special Populations== | ==Special Populations== | ||
*[[Drug Ratings in Pregnancy|Pregnancy Rating]]: | *[[Drug Ratings in Pregnancy|Pregnancy Rating]]: Category B Caution advised (esp in 2nd and 3rd trimester) | ||
*Lactation: | *Lactation: Possibly unsafe | ||
*Renal Dosing | *Renal Dosing | ||
**Adult | **Adult | ||
***CrCl 30-59: Give q24h | |||
***CrCl 10-29: Give q36-48h | |||
***CrCl <10: Individualize Dose | |||
***IV drug contraindicated with CrCl <40 | |||
**Pediatric | **Pediatric | ||
***Not defined | |||
*Hepatic Dosing | *Hepatic Dosing | ||
**Adult | **Adult | ||
***No Adjustment | |||
**Pediatric | **Pediatric | ||
***No Adjustment | |||
== Indications == | ==Indications== | ||
*Suppression of ventricular arrhythmias refractory to other meds | *Suppression of ventricular arrhythmias refractory to other meds | ||
*Suppression of SVT, a-fib | *Suppression of SVT, a-fib | ||
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==Contraindications== | ==Contraindications== | ||
*Allergy to class/drug | *Allergy to class/drug | ||
*[[Sinus bradycardia]] | |||
*[[Sick sinus syndrome]] w/o pacemaker | |||
*2nd or 3rd Degree [[AV block]] w/o pacemaker | |||
*Congenital or acquired [[QT prolongation]] | |||
*Baseline QTc > 450 msec | |||
*Decompensated heart failure | |||
*[[Cardiogenic shock]] | |||
*CrCl < 40 (IV use) | |||
*Bronchospastic disorders | |||
==Adverse Reactions== | ==Adverse Reactions== | ||
*Hypotension | ===Serious=== | ||
*[[Hypotension]] | |||
*[[Bradycardia]] | |||
*Proarrhythmia (esp in patients with [[hypokalemia]]) | *Proarrhythmia (esp in patients with [[hypokalemia]]) | ||
*[[Congestive heart failure]] | |||
*[[QT Prolongation]] | |||
*[[Torsades de pointes]] | |||
*[[Lupus erythematosus]] | |||
===Common=== | |||
*[[Fatigue]] | |||
*Dizziness | |||
*[[Nausea]]/[[Vomiting]] | |||
*[[Diarrhea]] | |||
*Asthenia | |||
*Hyperhidrosis | |||
*[[Palpitations]] | |||
*[[Headache]] | |||
*Insomnia | |||
*[[Dyspepsia]] | |||
*Edema | |||
==Pharmacology== | ==Pharmacology== | ||
*Half-life: | *Half-life: 12h | ||
*Metabolism: | *Metabolism: None | ||
*Excretion: | *Excretion: Urine | ||
*Mechanism of Action: | *Mechanism of Action: | ||
**Class II - Nonselective beta-blocker | **Class II - Nonselective beta-blocker | ||
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==References== | ==References== | ||
<references/> | |||
[[Category:Pharmacology]] | [[Category:Pharmacology]] | ||
[[Category:Cardiology]] | |||
Revision as of 22:31, 23 September 2019
General
- Type: Beta blockers
- Dosage Forms: Tab (80 mg, 120 mg, 160 mg, 240 mg); Injection
- Common Trade Names: Sotalol
Adult Dosing
Ventricular arrhythmia, life-threatening
- 80-160 mg PO q12h
- Start: 80mg PO q 12h
- Max: 640 mg/day
- Taper over 1-2wk to D/C
- 75-150 mg IV q12h
- Start: 75 mg IV q12h
- Max: 600 mg/day
- Taper over 1-2wk to D/C
Pediatric Dosing
Ventricular arrhythmia, life-threatening
- <2 yo
- Dose based on BSA and age-specific factor
- 2+ yo, PO
- 90-180 mg/m^2/day PO divided TID
- Start: 90mg/m^2/day
- Max: 180mg/m^2/day
- 90-180 mg/m^2/day PO divided TID
- 2+ yo, IV
- 84-168mg/m^2/day IV divided TID
- Start: 84mg/m^2/day
- Max: 168mg/m^2/day
- 84-168mg/m^2/day IV divided TID
Special Populations
- Pregnancy Rating: Category B Caution advised (esp in 2nd and 3rd trimester)
- Lactation: Possibly unsafe
- Renal Dosing
- Adult
- CrCl 30-59: Give q24h
- CrCl 10-29: Give q36-48h
- CrCl <10: Individualize Dose
- IV drug contraindicated with CrCl <40
- Pediatric
- Not defined
- Adult
- Hepatic Dosing
- Adult
- No Adjustment
- Pediatric
- No Adjustment
- Adult
Indications
- Suppression of ventricular arrhythmias refractory to other meds
- Suppression of SVT, a-fib
Contraindications
- Allergy to class/drug
- Sinus bradycardia
- Sick sinus syndrome w/o pacemaker
- 2nd or 3rd Degree AV block w/o pacemaker
- Congenital or acquired QT prolongation
- Baseline QTc > 450 msec
- Decompensated heart failure
- Cardiogenic shock
- CrCl < 40 (IV use)
- Bronchospastic disorders
Adverse Reactions
Serious
- Hypotension
- Bradycardia
- Proarrhythmia (esp in patients with hypokalemia)
- Congestive heart failure
- QT Prolongation
- Torsades de pointes
- Lupus erythematosus
Common
- Fatigue
- Dizziness
- Nausea/Vomiting
- Diarrhea
- Asthenia
- Hyperhidrosis
- Palpitations
- Headache
- Insomnia
- Dyspepsia
- Edema
Pharmacology
- Half-life: 12h
- Metabolism: None
- Excretion: Urine
- Mechanism of Action:
- Class II - Nonselective beta-blocker
- Class III effects (prolongs repol and refractoriness)
- Onset of action = 2-3hr
- Duration of action = 24hr