摘要:

The hemodynamic effects of amiodarone vary according to many factors which include the method of administration and each patient's medical conditon and histroy. Adverse effects of amiodarone are serious but can be minimized by appropriate dosage adjustments. At this time, amiodarone does not appear to cause significant deterioration of myocardial function even though there are risks of other serious adverse reactions.

ISSN:8756-9264    

DOI:10.1111/j.1540-8167.1986.tb01726.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

The ayitiarrhythmic properties of amiodarone in WPW‐syndrome depend on several simultaneously active mechanisms. Its electrophysiologic properties lead to reduction of excitabUity, lengthening of refractory periods and slowing of conduction. With these effects, it reduces premature ectopic beats and thus initiating events for tachycardias. The ventricular response during atrial fibrillation will be reduced in most but unfor‐tunately not all patients and tachycardia cycle length will be prolonged. Therefore amiodarone seems to be the drug of choice in WPW‐syndrome if there was not a high incidence of side‐effects and an extremely long tissue half‐life. The prescription has therefore to be made with caution since if once applied, its effects are not immediately renersible. Hoioever, in some cases it offers an alternative for surger

ISSN:8756-9264    

DOI:10.1111/j.1540-8167.1986.tb01727.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

Amiodrone is a benytfuran derivative with class III anti arrhythmic effects. It has also been reported to convert atrial fibrillation and flutter to sinus rhythm and is highly effective for the prevention of atrial fibrillation (especially of the paroxysmal form) with an overall efficacy in the range of 70–50%. This high degree of efficacy was obtained in a majority of patients who had already failed various conventional anti arrhythmic agents. The mechanism of arrhythmia termination by intravenous amiodarone is not clear. The slowing in ventricular response, which most probably improves cardiac hemodynamics, has an indirect salutary effect. Despite the fact that none of the published reports on intravenous amiodarone used a placebo control group, these studies suggest that intravenous amiodarone has an important role in the acute treatment of atrial fibrilation with fast ventricular respons

ISSN:8756-9264    

DOI:10.1111/j.1540-8167.1986.tb01728.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

Amiodarone has emerged as a potent agent for the management of patietits with reentrant supra ventricular tachycardias, atrial flutter, atrial fibrillation, and dysrhythmias associated with the preexcitation syndromes. Efficacy is reported betiveen 50 and 90% dependent upon the nature of the primary rhythm disturbance and population studied. Electrophysiological studies have not in general been helpful in predicting outcome with this agent. The drug may produce a wide array of toxic side effects, requiring cessation of therapy in less than 10% of patients. Our approach to the use of this agent relegates it to a second or third line of therapy in view of its complex pharmacokinetics and wide array of side effects.

ISSN:8756-9264    

DOI:10.1111/j.1540-8167.1986.tb01729.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

The reported world clinical experience of amiodarone in children is revieived; the known age‐dependent electro physiological and pharmacokinetic characteristics of amiodarone are examined; and guidelines for the use of amiodarone in children are suggeste

ISSN:8756-9264    

DOI:10.1111/j.1540-8167.1986.tb01730.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

Propafenone is an effective agent for suppression of chronic ventricular ectopic depolarizations. Complete elimination of nonsustained ventricular tachycardia is achieved in most patients treated with propafenone. The efficacy of propafenone is best correlated with its prolongation of the PR and QRS intervals whereas its plasma level is a poor predictor of therapeutic efficacy. Although serious side effects do occur with propafenone therapy and the drug must be discontinued in some patients, successful therapy of patients for up to four years has been reported.

ISSN:8756-9264    

DOI:10.1111/j.1540-8167.1986.tb01731.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

Propafenone is a new anti arrhythmic agent with primarily membrane‐stabilizing action. Three U.S. controlled double‐blind cross‐over studies demonstrated the efficacy of propafenone in suppressing ventricular premature complexes (VPCs), including repetitive forms: 67–83% of patients had greater than 80% reduction of VPCs, 62% achieved greater than 90% reduction of couplets and 80%–100% achieved 200% abolition of ventricular tachycardia runs. Other studies showed that propafenone is effective in controlling ventricular arrhythmias refractory to conventional anti arrhythmic agents. Propafenone is at least as effective as these agents. Long‐term sustained efficacy of propafenone was shown in some preliminary studies. Because of the variation in individual response to the drug, therapy should be individualized for each patient. Propafenone is well tolerated: side effects of propafenone are few and involve mostly the cardiac conduction system. Propafenone would be a significant addition to the anti arrhythmic ar

ISSN:8756-9264    

DOI:10.1111/j.1540-8167.1986.tb01732.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

The combined occurrence of left ventricular dysfunction and ‐ventricular tachyarrhythmias portends a high annual mortality. Anti arrhythmic drugs can ameliorate ventricular arrhythmia and may reduce the risk of sudden cardiac death. We administered propafenone to 15 patients with ventricular tachyarrhythmias and left ventricular ejection fractions 40%. Propafenone significantly reduced isolated ventricular premature depolarizations, couplets, and ventricular tachycardia on ambulatory monitoring. Propafenone eliminated all exercise provocable ventricular tachycardia. Propafenone additionally abolished ventricular tachycardia inducible by programmed stimulation in 4 of 7 patients. In 8 patients studied before and during therapy, there was no significant change in left ventricular ejection fraction as determined by nuclear ventriculography. Propafenone was discontinued in 4 patients due to side effects. Seven patients receiving continuing propafenone therapy remain alive with only one patient suffering arrhythmia recurrence. Propafenone is an effective drug for the management of ventricular tachyarrhythmias and may be used for patients with impaired left ventricular functio

ISSN:8756-9264    

DOI:10.1111/j.1540-8167.1986.tb01733.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

The pharmacokinetics of mexiletine and the factors that have been shown to modify its disposition are reviewed. The clinical significance of the modifications observed is discussed. Mexiletine is well absorbed from the gut and the bioavailability is 80–88%, The volume of distribution is large (5–9 L/kg) and 70% of the drug is bound to serum proteins. The elimination half‐life varies between 6–12 hours. Concomitant administration of atropine, metoclopramide, gastric acids, narcotic analgesics and cimetidine modify the peak concentrations of mexiletine and the time required to attain these concentrations. Rifampicin, phenytoin, and cigarette smoking shorten the elimination half‐life and increase the clearance. The volume of distribution of mexiletine is increased to the acute phase of myocardial infarction, whereas its elimination half‐life is increased in both cardiac failure and cirrhosis. Factors modifying the elimination, unlike those affecting the absorption characteristics, of mexiletine are of clinical importance and may require a modification of the dos

ISSN:8756-9264    

DOI:10.1111/j.1540-8167.1986.tb01734.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

The clinical experience with mexiletine in combination with other anti arrhythmic drugs, particularly those with auinidine‐like electrophysiological properties, strongly suggests that its efficacy can be significantly enhanced. Likewise, combinations of drugs with similar electrophysiological properties have also been reported to be effective; however, this treatment strategy may simply reflect the fact that side effects can be minimized with the lower drug dosages used in combination therapy. Prediction of potentially beneficial and potentially harmful combinations may be possible; however, any proposed drug combination should be subjected to appropriate clinical testing before it is widely adopte

ISSN:8756-9264    

DOI:10.1111/j.1540-8167.1986.tb01735.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY