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<< Emergency Department Management Of Calcium-Channel Blocker, Beta Blocker, And Digoxin Toxicity

Special Circumstances

Sotalol, a beta blocker with inward-K channelblocking activity, has the potential to prolong the QT interval and induce ventricular dysrhythmias, including torsades de pointes.123 Sotalol toxicity that presents with bradycardia and hypotension should be treated as any other beta blocker; however, if the patient is demonstrating torsades de pointes, standard treatments such as magnesium or overdrive pacing should be considered.93 Given the high benefit-to-risk ratio, it is reasonable to administer magnesium sulfate prophylactically in patients who present with a sotalol ingestion and prolonged QTc.

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