Sotalol [soe' toe lol]:
(Class II, Beta-Adrenergic Receptor and Potassium Channel Blocker)

  • Sotalol is a nonselective beta-adrenergic receptor antagonist that also blocks potassium currents.

  • Sotalol prolongs action potential duration, decreases automaticity, slows impulse transmission through the AV node and prolongs AV nodal refractoriness.

  • It is used in management of ventricular tachyarrhythmias and is also used in treatment of atrial arrhythmias.

  • Antiarrhythmic effects are due both to beta-adrenergic receptor and potassium channel blockade.

  • Normally, sympathetic drive results in increased in Ca2+ ,K+ ,and Cl- currents.

    • Increased sympathetic tone also increases phase 4 depolarization (heart rate goes up), and increases DAD (delayed afterdepolarizations) and EAD (early afterdepolarization) mediated arrhythmias.

    • These effects are blocked by beta-adrenergic receptor blockers.

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