Q: Sotalol should be used with caution in patients with? (select one)
A) liver insufficiency
B) renal insufficiency
Answer: B
Sotalol is unique because it gets 100% absorbed, is not metabolized, and has 100% bioavailability - without any significant effect due to age or food.
It has no first-pass effect and is excreted exclusively via kidneys. The dosing interval must be modified according to creatinine clearance and glomerular filtration rate (GFR).
#pharmacology
References:
1. Antonaccio MJ, Gomoll A. Pharmacology, pharmacodynamics and pharmacokinetics of sotalol. Am J Cardiol 1990; 65:12A.
2. Rizza C, Valderrabano M, Singh BN. Recurrent Torsades de Pointes After Sotalol Therapy for Symptomatic Paroxysmal Atrial Fibrillation in a Patient with End-Stage Renal Disease. J Cardiovasc Pharmacol Ther 1999; 4:129.
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