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In the kidneys, dofetilide is eliminated via cation exchange (secretion). Agents that interfere with the renal cation exchange system, such as verapamil, cimetidine, hydrochlorothiazide, itraconazole, ketoconazole, prochlorperazine, and trimethoprim should not be administered to individuals taking dofetilide.
Excessive QT prolongation can trigger tachycardias such as torsades de pointes (TdP). QT prolongation is an established side effect of antiarrhythmics, but can also be caused by a wide range of non-cardiac medicines, including antibiotics, antidepressants, antihistamines, opioids, and complementary medicines.
Dronedarone has been termed a "multichannel blocker". [citation needed] However, it is unclear which channel(s) play a pivotal role in its success. [9]Thus, dronedarone's actions at the cellular level are controversial, with most studies suggesting an inhibition in multiple outward potassium currents including rapid delayed rectifier, slow delayed rectifier and ACh-activated inward rectifier. [10]
The system is therefore sometimes known as the Singh-Vaughan Williams classification. The five main classes in the Vaughan Williams classification of antiarrhythmic agents are: Class I agents interfere with the sodium (Na +) channel. Class II agents are anti-sympathetic nervous system agents. Most agents in this class are beta blockers.
Torsades de pointes, torsade de pointes or torsades des pointes (TdP; also called torsades) (/ t ɔːr ˌ s ɑː d d ə ˈ p w æ̃ t /, [2] French: [tɔʁsad də pwɛ̃t̪], translated as "twisting of peaks") is a specific type of abnormal heart rhythm that can lead to sudden cardiac death.
The cardiac features of JLNS can be diagnosed by measuring the QT interval corrected for heart rate (QTc) on a 12-lead electrocardiogram (ECG). The QTc is less than 450 ms in 95% of normal males, and less than 460 ms in 95% of normal females. In those with Jervell and Lange-Nielsen syndrome the QTc is typically greater than 500 ms. [8]
Here are links to possibly useful sources of information about Dofetilide. PubMed provides review articles from the past five years (limit to free review articles) The TRIP database provides clinical publications about evidence-based medicine. Other potential sources include: Centre for Reviews and Dissemination and CDC
Bictegravir should not be used with dofetilide and rifampin. [16] Use of dofetilide with bictegravir increases the concentration of dofetilide, which can lead to life-threatening events. [ 16 ] Concomitant use of bictegravir and rifampin causes significant interactions because of an effect rifampin has on bictegravir. [ 16 ]