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Questions and Answers
What is the primary therapeutic use of Disopyramide?
What is the primary therapeutic use of Disopyramide?
- Chest pain
- Ventricular arrhythmia (correct)
- Hypertension
- Atrial flutter
In which scenario should the dose of Disopyramide be adjusted?
In which scenario should the dose of Disopyramide be adjusted?
- In patients with liver disease
- In patients with hyperkalemia
- When the patient is on diuretics
- If creatinine clearance is less than 40 mL/min (correct)
What is a contraindication for using Disopyramide?
What is a contraindication for using Disopyramide?
- Heart failure
- Hypertension
- Atrial fibrillation
- Myasthenia gravis (correct)
Which of the following is a serious side effect associated with Disopyramide?
Which of the following is a serious side effect associated with Disopyramide?
What is the recommended therapeutic range for Disopyramide?
What is the recommended therapeutic range for Disopyramide?
Which condition warrants caution when prescribing Disopyramide due to its potential effects on heart function?
Which condition warrants caution when prescribing Disopyramide due to its potential effects on heart function?
What significant monitoring is required for patients receiving Disopyramide due to its risk of serious cardiovascular events?
What significant monitoring is required for patients receiving Disopyramide due to its risk of serious cardiovascular events?
Which of the following statements regarding drug interactions with Disopyramide is correct?
Which of the following statements regarding drug interactions with Disopyramide is correct?
What condition is specifically listed as a contraindication for the use of Disopyramide?
What condition is specifically listed as a contraindication for the use of Disopyramide?
What is a common side effect associated with Disopyramide usage due to its anticholinergic properties?
What is a common side effect associated with Disopyramide usage due to its anticholinergic properties?
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Study Notes
Disopyramide (Norpace®)
- Oral (PO) medication used for life-threatening ventricular arrhythmias
- Off-label use for supraventricular dysrhythmias, leveraging its anticholinergic properties
- Metabolized by the liver (CYP3A4) and excreted by the kidneys
- Dose adjustment is required for patients with creatinine clearance (CrCl) below 40 mL/min
- Therapeutic range: 2-5 mcg/mL
- Black Box Warning (BBW): Reserved for life-threatening ventricular dysrhythmias due to increased mortality
- Contraindications: Long QT syndrome, 2nd or 3rd degree heart block, Cardiogenic shock, myasthenia gravis
- Precautions: Increased QRS or QT interval, heart failure exacerbation (decreased inotropic effect), hypoglycemia, caution with increased or decreased potassium levels
- Common side effects: Anticholinergic effects
- Serious side effects: Increased QTc interval, Torsades de Pointes (TdP), heart failure exacerbation, hypotension, AV block
- Drug interactions: CYP3A4 inducers or inhibitors can affect disopyramide levels, QT prolonging drugs increase risk of TdP
- For supraventricular dysrhythmias, a digoxin loading dose is recommended before therapy to protect the AV node
Disopyramide (Norpace®)
- Oral medication for the treatment of life-threatening ventricular arrhythmias.
- Off-label use: Supraventricular dysrhythmias, due to anticholinergic properties.
- Metabolism: Primarily metabolized in the liver via CYP3A4 and excreted by the kidneys. Dose adjustment required for patients with creatinine clearance (CrCl) less than 40 mL/min.
- Therapeutic range: 2-5 mcg/mL.
- Black Box Warning: Reserved for patients with life-threatening ventricular dysrhythmias due to increased mortality.
- Contraindications: Long QT syndrome, second or third-degree heart block, cardiogenic shock, myasthenia gravis.
- Precautions: Monitor for prolongation of QRS or QT interval, exacerbation of heart failure (decreased inotropic effect), hypoglycemia, and monitor potassium levels (carefully in patients with high or low levels).
- Common side effects: Anticholinergic effects.
- Serious side effects: Prolonged QT interval, Torsades de Pointes (TdP), heart failure exacerbation, hypotension, and atrioventricular (AV) block.
- Drug Interactions: Interactions with CYP3A4 inducers and inhibitors, as well as QT prolonging medications (increased risk of TdP).
- Important consideration for supraventricular dysrhythmias: Consider loading with digoxin prior to therapy to protect the AV node.
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