Title: Sotalol - watch out, review med list
题目：索他洛尔－小心，要检查药单
Author 作者: Fermin Barrueto

When reviewing a patient's medication list, there are always some that should catch your eyes. Digoxin is one since we can measure it, has a low therapeutic index and elimination is effected when renal function is diminished. Another drug that should catch your eyes is SOTALOL. Renally cleared and affected by even a minimally lower than normal magnesium. The toxic effect even at therapeutic levels is torsades de pointes.
审查病人的用药清单时，总会有一些吸引您的眼球。地高辛是其中之一，因为我们可以测量它，治疗指数低，当肾功能减退时，它的排除会受影响。应该抓住你眼球的另一种药物是索他洛尔。它是由肾脏清除和甚至稍低一点的镁也会影响其作用。即使在治疗水平的毒性作用是尖端扭转型室速。
One study, in a 736 bed hospital, showed 89% of patients prescribed sotalol were on an inappropriate dose due to renal function and an odds ratio of 3.7 increased re-admission rate at 6 months for the patients on the inappropriate dose of sotalol.
一个来自于736张病床的医院研究显示，有89％的患者服用与肾功能不相符剂量的索他洛尔；服用不合适索他洛尔剂量会使病人在6个月时的再住院的机率增加3。7倍。
We can catch this in the ED. Involve your pharmacist, ED pharmacist or local toxicologist for dosing calculations.
我们可以在急诊科发现这一问题。在确定剂量时，可征求您的药剂师，ED的药剂师或当地毒理学中心。
References 参考文献：
 
Assessment of sotalol prescribing in a community hospital: opportunities for clinical pharmacist involvement. Finks SW, Rogers KC, Manguso AH. Int J Pharm Pract. 2011 Aug;19(4):281-6.