p.23 抽出テキスト

Table 7.  Ongoing Drug Therapy for SVT, Oral Administration*

Drug Initial Daily Dose(s) Maximum Total Daily

Maintenance Dose Potential Adverse

Effects Precautions (Exclude or Use With Caution) and Interactions

Beta blockers

Atenolol 25–50 mg QD 100 mg QD (reduced dosing in patients with severe renal dysfunction) Hypotension, bronchospasm, bradycardia •  AV block greater than first degree or SA node dysfunction (in absence of pacemaker)

•  Decompensated systolic HF •  Hypotension •  Reactive airway disease •  Severe renal dysfunction •  Drugs with SA and/or AV nodal–blocking properties

Metoprolol tartrate 25 mg BID 200 mg BID Hypotension, bronchospasm, bradycardia •  AV block greater than first degree or SA node dysfunction (in absence of pacemaker)

•  Decompensated systolic HF •  Hypotension •  Reactive airway disease •  Drugs with SA and/or AV nodal–blocking properties

Metoprolol succinate (long-acting) 50 mg QD 400 mg QD Hypotension, bronchospasm, bradycardia •  AV block greater than first degree or SA node dysfunction (in absence of pacemaker)

•  Decompensated systolic HF •  Hypotension •  Reactive airway disease •  Drugs with SA and/or AV nodal–blocking properties

Nadolol 40 mg QD 320 mg QD (reduced dosage with renal impairment) Hypotension, bronchospasm, bradycardia •  AV block greater than first degree or SA node dysfunction (in absence of pacemaker)

•  Reactive airway disease •  Cardiogenic shock •  Decompensated HF •  Hypotension •  Renal dysfunction •  Drugs with SA and/or AV nodal–blocking properties

Propranolol 30–60 mg in divided or single dose with longacting formulations 40–160 mg in divided or single dose with long-acting formulations Hypotension, worsening HF, bronchospasm, bradycardia •  AV block greater than first degree or SA node dysfunction (in absence of pacemaker)

•  Reactive airway disease •  Decompensated systolic HF •  Hypotension •  Drugs with SA and/or AV nodal–blocking properties

Nondihydropyridine calcium channel antagonists

Diltiazem 120 mg daily in divided or single dose with longacting formulations 360 mg daily in divided or single dose with long-acting formulations Hypotension, worsening HF in patients with pre-existing ventricular dysfunction, bradycardia, abnormal liver function studies, acute hepatic injury (rare) •  AV block greater than first degree or SA node dysfunction (in absence of pacemaker) •  Hypotension† •  Decompensated systolic HF/severe LV dysfunction •  WPW with AF/atrial flutter •  Drugs with SA and/or AV nodal–blocking properties •  Diltiazem is a substrate of CYP3A4 (major) and a moderate CYP3A4 inhibitor •  Apixaban, itraconazole, bosutinib, ceritinib, cilostazol, cyclosporine, everolimus, ibrutinib, idelalisib, ivabradine, lomitapide, olaparib, ranolazine, rifampin, simeprevir

(Continued )

Downloaded from http://ahajournals.org by on October 7, 2026