title: Managing geriatric arrhythmias, II: Drug selection and use.
abstract: Age-related impairments in antiarrhythmic drug distribution, metabolism, and excretion may result in accumulation of these potent drugs, increasing the risk of adverse drug reactions and drug interactions in the elderly. These risks are minimized by using modest initial dosage with slow dosage titration. Therapeutic drug monitoring is a method which employs antiarrhythmic concentration data and a determination of drug clearance in order to develop an optimal dosing regimen. The pharmacology, indications for use, and adverse effects of currently available antiarrhythmics are reviewed. Dosing guidelines for the geriatric population are provided.
authors.affiliation: Presbyterian Medical Center, Philadelphia.
authors.forename: R A
authors.initials: RA
authors.lastname: Lynch
authors.forename: L N
authors.initials: LN
authors.lastname: Horowitz
mesh_terms: D000368:Aged; D000375:Aging / Q000378:metabolism*; D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000378:metabolism / Q000493:pharmacokinetics; D001145:Arrhythmias, Cardiac / Q000188:drug therapy* / Q000378:metabolism; D004334:Drug Administration Schedule; D004347:Drug Interactions; D006801:Humans; D007668:Kidney / Q000378:metabolism
chemical_list: D000889:Anti-Arrhythmia Agents