Disopyramide

Details About Generic Salt ::  Disopyramide 

Main Medicine Class:: Cardiovascular System   Sub Medicine Class ::  Anti Arrhythmics

4B. ANTI-ARRHYTHMICS in 4. CARDIOVASCULAR SYSTEM
DISOPYRAMIDE
PYRIDINE DERIVATIVE | ANTI-ARRHYTHMIC (CLASS IA)
PK: A: Rapid & complete D: 0.8-2 L/kg (Vd) M: Hepatic E: Urine

Indications & Dose: SUPRAVENTRICULAR/VENTRICULAR ARRHYTHMIAS PO Adult 300-800mg/day in divided doses Child <1 yr: 10-30mg/kg/day, 1-4 yr: 10-20mg/kg/day, 4-12 yr: 10-15mg/kg/day, 12-18 yr: 6-15mg/kg/day | IV Adult Inj: 2mg/kg slowly (rate not exceeding 30mg/min), max 150mg, then 200mg PO immediately & q8h for 24h. For recurrence total IV dose 4mg/kg (max 300mg) may be repeated but should not be exceeded in the first hour, nor should the total by both IV & PO routes exceed 800 mg/day | VENTRICULAR TACHYCARDIA PO Adult <50 kg: 100mg q6h or 200mg q12h, >50 kg: 150mg q6h or 300mg q12h, increase to 200mg q6h if no response max 400mg q6h (patients with severe refractory ventricular tachycardia) Child <1 yr: 10-30mg/kg/day, 1-4 yr: 10-20mg/kg/day, 4-12 yr: 10-15mg/kg/day, 12-18 yr: 6-15mg/kg/day

Contra: Hypersensitivity, cardiogenic shock, pre-existing second/third-degree heart block, congenital QT syndrome, sick sinus syndrome

Precautions: HF, LVD, conduction disturbances, hepatic/renal insufficiency, prostate enlargement, myasthenia gravis, glaucoma, DM

ADR: Serious: HF, heart block, arrhythmia, thrombocytopenia, agranulocytosis, hypoglycemia, syncope, chest pain, orthostatic hypotension, blurred vision, angle-closure glaucoma, jaundice, edema, Others: decreased appetite, weight gain, hypokalemia, myalgia, dyspnea, rash, dry eyes, nausea, vomiting, diarrhea, constipation, abdominal pain, dry mouth, urinary hesitancy/retention, erectile dysfunction, anemia, Dizziness, agitation, depression, fatigue, headache, nervousness, acute psychosis

DDI: Serious Antidiabetics causes hypoglycemia, Verapamil causes profound hypotension & collapse, Metoprolol/Atenolol/Pindolol/Sotalol causes severe bradycardia, Ritonavir increases drug levels, Amiodarone increases risk of QT interval prolongation & torsade de pointes, Warfarin increases the risk/severity of bleeding, Erythromycin leads to QT prolongation, cardiac arrhythmia & heart block, Clarithromycin leads to torsade de pointes, ventricular fibrillation & severe hypoglycemia, Azithromycin leads to ventricular fibrillation, Paliperidone prolongs the QT interval, Phenytoin/Phenobarbital/Rifampicin reduces serum drug levels

Diet: On empty stomach

Monitor: ECG, BP, urinary retention, CNS anticholinergic effects (confusion, agitation, hallucinations, etc)

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