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Consult Pharm. 2014 Apr;29(4):270-4. doi: 10.4140/TCP.n.2014.270.

Considerations for dofetilide use in the elderly.

Author information

  • 1Department of Clinical and Administrative Sciences, Notre Dame of Maryland University School of Pharmacy, Baltimore, Maryland.
  • 2Department of Pharmacotherapy and Outcomes Science, Virginia Commonwealth University School of Pharmacy, Richmond.

Abstract

This case describes an 85-year-old African-American female with atrial arrhythmias on dofetilide maintenance therapy who presented to an ambulatory cardiology clinic with hypotension. The pharmacist identified a potential major drug-drug interaction between dofetilide and the thiazide diuretic, chlorthalidone. Because of the patient's hypotension, it was decided to discontinue chlorthalidone to avoid the potential drug interaction with dofetilide. A systolic BP goal of 140-145 mmHg was later achieved and maintained with the addition of low-dose amlodipine, in addition to her lisinopril. This case highlights important considerations for prescribing and monitoring dofetilide and reviews hypertension management in the elderly population.

KEYWORDS:

AF = Atrial fibrillation; BP = Blood pressure; CPC = Cardiopharmacotherapy clinic; Chlorthalidone; Diuretics; Dofetilide; Drug interactions; ECG = Electrocardiogram; HCTZ = Hydrochlorothiazide; HTN = Hypertension; IU = International units; PAC = Premature atrial contractions; TdP = Torsades de pointes; Thiazide

PMID:
24704896
[PubMed - indexed for MEDLINE]
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