Sotalol tablet overdosage: Difference between revisions
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== | ==Overdosage== | ||
Intentional or accidental overdosage with Betapace (sotalol hydrochloride) has rarely resulted in death. | |||
====Symptoms and Treatment of Overdosage==== | |||
<ref name="dailymed.nlm.nih.gov">{{Cite web | last = | first = | title = BETAPACE (SOTALOL HYDROCHLORIDE) TABLET [BAYER HEALTHCARE PHARMACEUTICALS INC.] | url = http://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=c4caf469-f684-4f6d-98e8-b6a2fff1de98 | publisher = | date = | accessdate = }}</ref> | The most common signs to be expected are bradycardia, congestive heart failure, hypotension, bronchospasm and hypoglycemia. In cases of massive intentional overdosage (2-16 grams) of Betapace the following clinical findings were seen: hypotension, bradycardia, cardiac asystole, prolongation of QT interval, Torsade de Pointes, ventricular tachycardia, and premature ventricular complexes. If overdosage occurs, therapy with Betapace should be discontinued and the patient observed closely. Because of the lack of protein binding, hemodialysis is useful for reducing sotalol plasma concentrations. Patients should be carefully observed until QT intervals are normalized and the heart rate returns to levels >50 bpm. The occurrence of hypotension following an overdose may be associated with an initial slow drug elimination phase (half life of 30 hours) thought to be due to a temporary reduction of renal function caused by the hypotension. In addition, if required, the following therapeutic measures are suggested: | ||
<u>'''Bradycardia or Cardiac Asystole'''</u>: Atropine, another anticholinergic drug, a beta-adrenergic agonist or transvenous cardiac pacing. | |||
<u>'''Heart Block'''</u>: (second and third degree) transvenous cardiac pacemaker. | |||
<u>'''Hypotension'''</u>: (depending on associated factors) epinephrine rather than isoproterenol or norepinephrine may be useful. | |||
<u>'''Bronchospasm'''</u>: Aminophylline or aerosol beta-2-receptor stimulant. | |||
<u>'''Torsade de Pointes'''</u>: DC cardioversion, transvenous cardiac pacing, epinephrine, magnesium sulfate.<ref name="dailymed.nlm.nih.gov">{{Cite web | last = | first = | title = BETAPACE (SOTALOL HYDROCHLORIDE) TABLET [BAYER HEALTHCARE PHARMACEUTICALS INC.] | url = http://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=c4caf469-f684-4f6d-98e8-b6a2fff1de98 | publisher = | date = | accessdate = }}</ref> | |||
==References== | ==References== | ||
Revision as of 06:00, 10 February 2014
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overdosage
Intentional or accidental overdosage with Betapace (sotalol hydrochloride) has rarely resulted in death.
Symptoms and Treatment of Overdosage
The most common signs to be expected are bradycardia, congestive heart failure, hypotension, bronchospasm and hypoglycemia. In cases of massive intentional overdosage (2-16 grams) of Betapace the following clinical findings were seen: hypotension, bradycardia, cardiac asystole, prolongation of QT interval, Torsade de Pointes, ventricular tachycardia, and premature ventricular complexes. If overdosage occurs, therapy with Betapace should be discontinued and the patient observed closely. Because of the lack of protein binding, hemodialysis is useful for reducing sotalol plasma concentrations. Patients should be carefully observed until QT intervals are normalized and the heart rate returns to levels >50 bpm. The occurrence of hypotension following an overdose may be associated with an initial slow drug elimination phase (half life of 30 hours) thought to be due to a temporary reduction of renal function caused by the hypotension. In addition, if required, the following therapeutic measures are suggested:
Bradycardia or Cardiac Asystole: Atropine, another anticholinergic drug, a beta-adrenergic agonist or transvenous cardiac pacing.
Heart Block: (second and third degree) transvenous cardiac pacemaker.
Hypotension: (depending on associated factors) epinephrine rather than isoproterenol or norepinephrine may be useful.
Bronchospasm: Aminophylline or aerosol beta-2-receptor stimulant.
Torsade de Pointes: DC cardioversion, transvenous cardiac pacing, epinephrine, magnesium sulfate.[1]
References
Adapted from the FDA Package Insert.