[.
]Action/Kinetics:
Blocks both beta-1- and beta-2-adrenergic receptors; has no membrane-stabilizing activity or intrinsic sympathomimetic activity. Has both Group II and Group III antiarrhythmic properties (dose dependent). Significantly increases the refractory period of the atria, His-Purkinje fibers, and ventricles. Also prolongs the QTc and JT intervals. t1/2: 12 hr. Not metabolized; excreted unchanged in the urine.
Uses:
Treatment of documented ventricular arrhythmias such as life-threatening sustained VT. Reduction and delay in incidence of atrial fibrillation/flutter in those with normal sinus rhythm who have a recent history of atrial fibrillation/flutter that causes severe or disabling symptoms.
Contraindications:
Use in asymptomatic PVCs or supraventricular arrhythmias due to the proarrhythmic effects of sotalol. Congenital or acquired long QT syndromes. Use in clients with hypokalemia or hypomagnesemia until the imbalance is corrected, as these conditions aggravate the degree of QT prolongation and increase the risk for torsades de pointes.
Special Concerns:
Clients with sustained ventricular tachycardia and a history of CHF appear to be at the highest risk for serious proarrhythmia. Dose, presence of sustained ventricular tachycardia, females, excessive prolongation of the QTc interval, and history of cardiomegaly or CHF are risk factors for torsades de pointes. Use with caution in clients with chronic bronchitis or emphysema and in asthma if an IV agent is required. Use with extreme caution in clients with sick sinus syndrome associated with symptomatic arrhythmias due to the increased risk of sinus bradycardia, sinus pauses, or sinus arrest. Reduce dosage in impaired renal function. Safety and efficacy in children have not been established.
Additional Side Effects:
CV: New or worsened ventricular arrhythmias, including sustained VT or ventricular fibrillation that might be fatal. Torsades de pointes.
How Supplied:
Tablet: 80 mg, 120 mg, 160 mg, 240 mg
Dosage
•Tablets
Ventricular arrhythmias.
Adults, initial: 80 mg b.i.d. The dose may be increased to 240 or 320 mg/day after appropriate evaluation. Usual: 160-320 mg/day given in two or three divided doses. Clients with life-threatening refractory ventricular arrhythmias may require doses ranging from 480 to 640 mg/day (due to potential proarrhythmias, use these doses only if the potential benefit outweighs the increased risk of side effects).
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