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Sotalol

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Structure

  • Sotalol is a class III antiarrhythmic agent with both beta-blocking (class II) and potassium channel-blocking (class III) properties. It features a non-selective beta-adrenergic receptor antagonist core linked to a benzothiazole moiety.

  • Chemical Formula: C₁₄H₁₆N₂O₃S

    Chemical Formula of Sotalol
Structure of Sotalol
Structure of Sotalol

Mode of Action

  • Class III Antiarrhythmic: Blocks potassium channels, prolonging repolarization, action potential duration, and refractory period.

  • Class II Antiarrhythmic: Non-selectively blocks beta-adrenergic receptors, reducing heart rate and myocardial contractility.

  • Effect on Heart Rate: Slows heart rate and reduces oxygen demand by the heart.

Uses

  • Ventricular Arrhythmias: Treats ventricular tachycardia and ventricular fibrillation.

  • Atrial Arrhythmias: Manages atrial fibrillation and atrial flutter by maintaining sinus rhythm.

  • Post-Myocardial Infarction: Prevents ventricular arrhythmias after myocardial infarction.

  • Reentrant Arrhythmias Prevention: Effective in preventing recurrence of various reentrant arrhythmias.

  • Long QT Syndrome: Used in specific arrhythmic syndromes involving prolonged QT intervals.

Side Effects of Sotalol

  • Proarrhythmic Effects: Risk of torsades de pointes due to QT interval prolongation.

  • Bradycardia: Excessive slowing of heart rate, especially in patients with existing conduction system disease.

  • Fatigue and Dizziness: Due to beta-blockade effects.

  • Electrolyte Imbalances: Hypokalemia and hypomagnesemia can increase proarrhythmic risks.

  • Bronchospasm: Non-selective beta-blockade can exacerbate asthma or COPD.


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