Anti-Arrhythmic Drugs

Question 1

sotalol

* class, indication, adverse effects

Answer 1

• d-sotalol is Class III and l-sotalol is Class II
• Indicated for maintaining sinus rhythm in atrial fibrillation and atrial flutter, prophylaxis of VT/VF
• Causes QT prolongation, torsades(2.4 - 4%). Use with caution in renal insufficiency

Question 2

dofetilide

Answer 2

• Class III agent
  • Indicated for atrial arrhythmias: Atrial flutter and fibrillation
• can use for patients with CHF
• caution: pt w/ renal insufficiency, drug coadmin (Drugs that interfere with CYP3A4can increase serum dofetilide levels. (Verapamil, cimetidine, HCTZ))
• Causes QT prolongation, with torsades occuring in 2-4% of patients

Question 3

amiodarone

Answer 3

• Mostly Class III, but has effects in all classes
• Useful in AF therapy and maintenance of NSR, VT, SVT, A flutter, VT/VF prophylaxis
  •Less prolongation of refractoriness in IV form, less efficacious for conversion of AF, but will often regularize
• side effects - pulm toxicity and thyroid dysfxn, Corneal and cutaneous bluish deposits with photosensitivity nearly ubiquitous,