Page 17 - RxExam's Naplex Theory Review Part-1

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Dose Special Notes

Sotalol 4. Patients with a history of symptomatic AFIB/AFL who are currently
(Tablet) receiving Sotalol (Betapace) for the maintenance of normal sinus rhythm
should be transferred to Betapace AF because of the significant
differences in labeling (i.e., patient package insert for Betapace AF,
dosing administration, and safety information).

5. Torsade de Pointes arrhythmia, bradycardia, dizziness and dyspnea
are reported side effects of Sotalol (Betapace).

Ibutilide 60 kg or more: 1 1. Ibutilide (Corvert) is indicated for the rapid conversion of atrial
(Injection) mg as a single fibrillation or atrial flutter of recent onset to sinus rhythm. Patients with
infusion. atrial arrhythmias of longer duration are less likely to respond to Ibutilide.

60 kg or less: 0.01 2. Ibutilide (Corvert) can cause potentially fatal arrhythmias, particularly
mg/kg as a single sustained polymorphic ventricular tachycardia, usually in association
infusion.
with QT prolongation (torsades de pointes), but sometimes without
documented QT prolongation.

3. Sustained and nonsustained polymorphic ventricular tachycardia,
hypotension, heart failure and bradycardia are reported adverse effects
of Ibutilide (Corvert).

Dofetilide 500 mcg PO BID. 1. Dofetilide (Tikosyn) is indicated for the maintenance of normal sinus
(Capsule) rhythm in patients with atrial fibrillation/atrial flutter of greater than
one week duration.

2. Torsade de pointes arrhythmia, ventricular arrhythmia, bradycardia
and heart failure are reported with the therapy.

Drug Interactions with Amiodarone:

Protease inhibitors Monitoring for amiodarone toxicity and serial measurement of
amiodarone serum concentration during concomitant protease
inhibitor therapy should be considered.

Loratadine QT interval prolongation and Torsade de Pointes have been
reported with the co-administration of loratadine and amiodarone.

Trazodone QT interval prolongation and Torsade de Pointes have been
reported with the co-administration of trazodone and amiodarone.

Grapefruit juice Grapefruit juice inhibits CYP3A4-mediated metabolism of oral
amiodarone in the intestinal mucosa, resulting in increased plasma
levels of amiodarone; therefore, grapefruit juice should not be
taken during treatment with oral amiodarone.

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