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Sotolol
(Betapace): |
Nonselective b-Blocker |
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Mixed Class II & Class III Antiarrhythmic |
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Sotolol
is an unusual type of b-blocker
in that it also has mixed class II and class III antiarrhythmic effects.
It can be used in the treatment of a wide range of problems, including
HTN, life-threatening ventricular arrhythmias, WPW, and in A fib/flutter to maintain
NSR after being converted.
Class III effects include prolonging the action potential and refractory
periods in both atrial and ventricular tissue, as well as in the AV node and its
bypass tract. Unfortunately,
its side effects are sufficiently dangerous as to severely restrict its use.
It is completely water soluble, and is totally excreted by the kidneys.
Dose:
Generally 80-320 mg BID depending on goal.
It is not given IV.
Side
Effects: Typical of b-blockers,
with the addition of ¯
HR, ¯
BP,
CHF, AV block, VF (esp torsades), and PVCs.
Contraindicated:
in asthma, CHF, 2°
or 3°
AV block, ¯
HR, ¯
BP, cardiogenic shock, and those with severe sinus node dysfunction. Use
cautiously in patients with renal impairement or DM.
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