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Annals of Internal Medicine Mar 1982Since disopyramide was introduced 5 years ago, the therapeutic spectrum of this drug in treating patients with ventricular and atrial arrhythmias has been found to be... (Review)
Review
Since disopyramide was introduced 5 years ago, the therapeutic spectrum of this drug in treating patients with ventricular and atrial arrhythmias has been found to be similar to that of the other type I antiarrhythmic drugs, quinidine and procainamide. Disopyramide has the potential to suppress sinus node function and, therefore, must be used cautiously in patients with the sick sinus syndrome. The available data indicate that it can be used safely in patients with bundle branch block and first-degree or type I second-degree atrioventricular block. Disopyramide has been found at times to precipitate ventricular tachycardia or ventricular fibrillation. Because this drug often causes decompensation in patients with congestive heart failure, it must be used very cautiously, if at all, in such patients.
Topics: Arrhythmias, Cardiac; Disopyramide; Drug Interactions; Electrophysiology; Heart; Heart Block; Humans; Kinetics; Pyridines; Sick Sinus Syndrome; Tachycardia; Ventricular Fibrillation
PubMed: 7036817
DOI: 10.7326/0003-4819-96-3-337 -
Annals of the New York Academy of... 1984
Review
Topics: Action Potentials; Animals; Arrhythmias, Cardiac; Coronary Disease; Disopyramide; Electrocardiography; Heart; Heart Conduction System; Humans; In Vitro Techniques
PubMed: 6395761
DOI: 10.1111/j.1749-6632.1984.tb14520.x -
Scottish Medical Journal Oct 1977
Review
Topics: Arrhythmias, Cardiac; Disopyramide; Hemodynamics; Humans; Kinetics; Pyridines
PubMed: 337485
DOI: 10.1177/003693307702200424 -
The New England Journal of Medicine Apr 1979
Topics: Anti-Arrhythmia Agents; Arrhythmias, Cardiac; Chemical Phenomena; Chemistry; Disopyramide; Heart; Heart Atria; Heart Ventricles; Humans; Myocardial Contraction; Myocardial Infarction; Pyridines; Tachycardia
PubMed: 431563
DOI: 10.1056/NEJM197904263001705 -
Pharmacotherapy Dec 2015Hypertrophic cardiomyopathy (HCM) is a genetic cardiac disorder characterized by unexplained left ventricular hypertrophy in the absence of other cardiac or systemic... (Review)
Review
Hypertrophic cardiomyopathy (HCM) is a genetic cardiac disorder characterized by unexplained left ventricular hypertrophy in the absence of other cardiac or systemic etiologies. Approximately two-thirds of patients with HCM develop left ventricular outflow tract (LVOT) obstruction with or without provocation, whereas nearly half develop heart failure with preserved ejection fraction. Medical management of heart failure with preserved ejection fraction is based on the presence of symptoms and LVOT obstruction and frequently includes β-blockers or verapamil. Disopyramide is a class Ia antiarrhythmic that historically was used for the treatment of arrhythmias; however, its contemporary use is often reserved for patients with HCM who are persistently symptomatic despite β-blockers or verapamil and have evidence of LVOT obstruction. The pharmacologic rationale for use of disopyramide is largely based on its strong negative inotropic property. Three clinical studies have showed significant improvements in heart failure symptoms and a reduction in the need for invasive therapy in patients treated with disopyramide. Appropriate dosing and monitoring of disopyramide are important to mitigate the potential for anticholinergic adverse events and proarrhythmias. Disopyramide is a safe and effective medication that reduces heart failure symptoms and LVOT gradient and delays the need for invasive therapy in patients with obstructive HCM.
Topics: Anti-Arrhythmia Agents; Cardiomyopathy, Hypertrophic; Disopyramide; Humans
PubMed: 26684556
DOI: 10.1002/phar.1664 -
European Heart Journal Mar 1987
Review
Topics: Arrhythmias, Cardiac; Disopyramide; Humans; Kinetics; Procainamide
PubMed: 3556173
DOI: 10.1093/eurheartj/8.suppl_a.11 -
Clinical Pharmacokinetics 1986Disopyramide is an antiarrhythmic agent with proven efficacy in the management of atrial and ventricular arrhythmias. The drug is well absorbed and undergoes virtually... (Review)
Review
Disopyramide is an antiarrhythmic agent with proven efficacy in the management of atrial and ventricular arrhythmias. The drug is well absorbed and undergoes virtually no first-pass metabolism. Peak concentrations are achieved approximately 0.5 to 3.0 hours after a dose. Absorption is reduced and slightly slowed in patients with acute myocardial infarction. Disopyramide is excreted as unchanged drug (two-thirds) or as the metabolite mono-N-desisopropyldisopyramide, with elimination via both renal and biliary routes. Elimination half-life is approximately 7 hours in normal subjects and patients, but is prolonged in patients with renal insufficiency (creatinine clearance less than 60 ml/min). Disopyramide exhibits complex protein binding. It is bound to alpha 1-acid glycoprotein (AAG), an acute phase reactant, and binds in a concentration-dependent (saturable) manner. The unbound fraction is reduced in the presence of elevated concentrations of AAG, as are found in acute myocardial infarction and in some chronic haemodialysis patients and renal transplant recipients. Free disopyramide concentrations are low relative to total concentration in these patients. Because the pharmacological effects of disopyramide are determined by unbound drug, changes in the unbound fraction could make total disopyramide concentrations misleading as a guide to therapy. Changes in protein binding do not, however, alter free disopyramide or metabolite concentrations, both of which are dependent only on dosage and intrinsic clearance. Free drug concentration measurement could potentially improve therapeutic monitoring, but is as yet of unproven clinical value. Disopyramide is cleared more rapidly in children than in adults, and therefore children require higher dosages to attain therapeutic concentrations.
Topics: Aged; Animals; Biotransformation; Blood Proteins; Child; Disopyramide; Heart Failure; Humans; Infant, Newborn; Intestinal Absorption; Kidney Diseases; Kinetics; Metabolic Clearance Rate; Myocardial Infarction; Protein Binding; Tissue Distribution
PubMed: 3524956
DOI: 10.2165/00003088-198611030-00003 -
Angiology Jun 1983Since its approval by the FDA six years ago, oral disopyramide has earned a recognized role in the treatment of ventricular arrhythmias. During this time, clinical... (Clinical Trial)
Clinical Trial Review
Since its approval by the FDA six years ago, oral disopyramide has earned a recognized role in the treatment of ventricular arrhythmias. During this time, clinical experience has refined our knowledge of this agent, allowing revision of dosing guidelines and better selection of patients. This review explores the recent therapeutic experience with disopyramide.
Topics: Arrhythmias, Cardiac; Clinical Trials as Topic; Disopyramide; Double-Blind Method; Humans; Parasympatholytics; Pyridines; Random Allocation; Ventricular Fibrillation
PubMed: 6346959
DOI: 10.1177/000331978303400601 -
Drugs Aug 1987Disopyramide is a widely used class IA antiarrhythmic drug with a pharmacological profile of action similar to that of quinidine and procainamide. Over the past 10 years... (Review)
Review
Disopyramide is a widely used class IA antiarrhythmic drug with a pharmacological profile of action similar to that of quinidine and procainamide. Over the past 10 years disopyramide has demonstrated its efficacy in ventricular and atrial arrhythmias. In therapeutic trials, usually involving small numbers of patients, the efficacy of disopyramide was comparable with that of mexiletine, perhexiline, tocainide, propafenone or prajmalium. Recent comparisons with quinidine have confirmed the similar efficacy and better tolerability of disopyramide. The suggestion from initial studies that disopyramide may be less effective than amiodarone or flecainide requires further investigation. In addition, studies have failed to demonstrate that the early administration of disopyramide after acute myocardial infarction decreases important arrhythmias or early mortality. Thus, disopyramide is now well established as an effective antiarrhythmic drug in ventricular and supraventricular arrhythmias although its role in therapy relative to that of recently introduced antiarrhythmic agents is not clear.
Topics: Arrhythmias, Cardiac; Disopyramide; Humans; Kinetics
PubMed: 3304965
DOI: 10.2165/00003495-198734020-00001 -
Journal of Forensic Sciences Nov 1987Disopyramide is an oral antiarrhythmic drug which reduces conduction velocity, prolongs duration of action potential and the effective refractory period, and exerts... (Review)
Review
Disopyramide is an oral antiarrhythmic drug which reduces conduction velocity, prolongs duration of action potential and the effective refractory period, and exerts vagolytic properties. The drug is usually well absorbed orally. The principal use of the drug is to suppress ventricular extrasystoles with usual oral dosage of 100 to 200 mg every 6 h, until blood levels of 2 to 4 micrograms/mL are attained. The use of the drug for suicide is uncommon as it is a prescription drug. Two cases of fatal disopyramide intoxication seen at the Los Angeles County Medical Examiner's Office will be discussed followed by a review of the literature of fatal suicidal disopyramide overdose. Case 1 was a 31-year-old male pharmacist with known history of depression and no history of heart disease. His decomposed remains were found with a suicide note and with several disopyramide tablets. At autopsy the blood level for disopyramide was 146 micrograms/mL. Case 2 is a 40-year-old male with history of alcoholism and prior suicidal attempts who regularly took disopyramide to control ventricular arrhythmias. He apparently ingested 36 100-mg tablets of disopyramide before his final collapse. At autopsy his blood level of disopyramide was 63 micrograms/mL.
Topics: Adult; Disopyramide; Humans; Male; Suicide
PubMed: 3323413
DOI: No ID Found