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Sotalol: a new class III antiarrhythmic agent
1Catherine McAuley Health Systems, St. Joseph Mercy Hospital, Ann Arbor, MI 48106.
Clinical Pharmacy
|December 1, 1993
Summary
Sotalol hydrochloride is a Class III antiarrhythmic and beta-blocker effective for ventricular and supraventricular arrhythmias. Review covers its chemistry, pharmacology, efficacy, and dosage, with adverse effects noted.
Area of Science:
- Pharmacology
- Clinical Therapeutics
- Cardiovascular Medicine
Background:
- Sotalol hydrochloride is a Class III antiarrhythmic agent with nonselective beta-blocking activity.
- It prolongs cardiac action potential and refractoriness, impacting electrophysiological properties.
Purpose of the Study:
- To review the chemistry, pharmacology, pharmacokinetics, clinical efficacy, adverse effects, and dosage of sotalol hydrochloride.
- To assess its utility in managing life-threatening arrhythmias.
Main Methods:
- Comprehensive literature review of sotalol hydrochloride.
- Analysis of pharmacokinetic data, clinical trial results, and adverse event reports.
Main Results:
- Sotalol is orally absorbed, eliminated renally with a 12-hour half-life, and effective for ventricular arrhythmias (VT, VF, PVCs) and supraventricular arrhythmias.
- Common adverse effects include fatigue, GI issues, and cardiovascular effects like bradycardia and AV block; 6-18% require discontinuation.
Conclusions:
- Sotalol hydrochloride is valuable for intractable ventricular arrhythmias and supraventricular arrhythmias unresponsive to other treatments.
- Appropriate dosing and monitoring are crucial due to potential adverse effects.