Disopyramide (Norpace®) Overview
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Questions and Answers

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 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?

  • Heart failure
  • Hypertension
  • Atrial fibrillation
  • Myasthenia gravis (correct)
  • Which of the following is a serious side effect associated with Disopyramide?

    <p>Torsades de Pointes (TdP)</p> Signup and view all the answers

    What is the recommended therapeutic range for Disopyramide?

    <p>2-5 mcg/mL</p> Signup and view all the answers

    Which condition warrants caution when prescribing Disopyramide due to its potential effects on heart function?

    <p>Heart failure</p> Signup and view all the answers

    What significant monitoring is required for patients receiving Disopyramide due to its risk of serious cardiovascular events?

    <p>QT interval duration</p> Signup and view all the answers

    Which of the following statements regarding drug interactions with Disopyramide is correct?

    <p>It has a significant interaction with CYP3A4 inducers and inhibitors.</p> Signup and view all the answers

    What condition is specifically listed as a contraindication for the use of Disopyramide?

    <p>Long QT syndrome</p> Signup and view all the answers

    What is a common side effect associated with Disopyramide usage due to its anticholinergic properties?

    <p>Dry mouth</p> Signup and view all the answers

    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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    Description

    This quiz covers the essential information regarding Disopyramide, a medication used primarily for life-threatening ventricular arrhythmias. Explore its uses, contraindications, dosage considerations, and potential side effects. Use this quiz to test your knowledge on its pharmacology and safety profile.

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