flecainide

出典: meddic

フレカイニド

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「oral antiarrhythmic medication (trade name Tambocor) used as a last resort in treating arrhythmias; increases the risk of sudden death in heart attack patients」
Tambocor

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出典(authority):フリー百科事典『ウィキペディア(Wikipedia)』「2014/02/15 23:49:57」(JST)

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英文文献

  • Three-month lower-dose flecainide after catheter ablation of atrial fibrillation.
  • Hayashi M1, Miyauchi Y, Iwasaki YK, Yodogawa K, Tsuboi I, Uetake S, Hayashi H, Takahashi K, Shimizu W.Author information 1Department of Cardiovascular Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan.AbstractAIMS: Atrial tachyarrhythmias (AT) commonly recur within the first 3 months after radiofrequency catheter ablation (RFCA) of atrial fibrillation (AF), and the influence of antiarrhythmic drugs (AADs) on the recurrences has not been fully elucidated. We sought to evaluate the efficacy of a 3-month lower-dose flecainide regime on early and late recurrences of ATs.METHODS AND RESULTS: We randomly assigned 126 patients, who underwent RFCA for AF, to the flecainide group (150 or 100 mg/day according to their body weight) or to the control group receiving no AADs. The primary endpoint was any AT lasting for ≥30 s during the first 3 months and the secondary endpoint was a composite of ATs lasting for ≥24 h or requiring cardioversion or hospitalization during the same period. All AADs were stopped after the first 3 months and the late arrhythmia recurrences were also evaluated. The primary endpoint rates were 37 and 41% in the flecainide (143 ± 19 mg/day) and control groups, respectively (log-rank P = 0.76), and those of the secondary endpoint were 10 and 14%, respectively (log-rank P = 0.45). The estimated rates of maintaining sinus rhythm at 12 months after the first 3 months were 78 and 72%, in the flecainide and control groups, respectively (log-rank P = 0.68), and the rates were 51 and 90% in those with and without the primary endpoint, respectively (log-rank P < 0.001).CONCLUSION: The 3-month lower-dose flecainide therapy after AF ablation did not reduce the early and late arrhythmia recurrences. The clinically significant ATs were also not prevented.
  • Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology.Europace.2014 Apr 4. [Epub ahead of print]
  • AIMS: Atrial tachyarrhythmias (AT) commonly recur within the first 3 months after radiofrequency catheter ablation (RFCA) of atrial fibrillation (AF), and the influence of antiarrhythmic drugs (AADs) on the recurrences has not been fully elucidated. We sought to evaluate the efficacy of a 3-month lo
  • PMID 24706088
  • [Brugada syndrome unmasked by oral flecainide in a patient with a history of supraventricular tachycardia.]
  • Díaz-Muñoz J1, García-Niebla J2.
  • Semergen / Sociedad Espanola de Medicina Rural y Generalista.Semergen.2014 Apr 2. pii: S1138-3593(14)00057-4. doi: 10.1016/j.semerg.2014.01.002. [Epub ahead of print]
  • PMID 24703583
  • Pharmacokinetic variability of flecainide in younger Japanese patients and mechanisms for renal excretion and intestinal absorption.
  • Horie A1, Ishida K, Shibata K, Taguchi M, Ozawa A, Hirono K, Ichida F, Hashimoto Y.Author information 1Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, 2630 Sugitani, Toyama, 930-0194, Japan.AbstractThe aims of the present study were to evaluate the variability of pharmacokinetics of flecainide in young Japanese patients and to investigate the mechanisms of renal excretion and intestinal absorption of the drug using cultured epithelial cells. First the plasma concentration data of flecainide was analysed in 16 Japanese patients aged between 0.07 and 18.30 years using a one-compartment model. Considerable interindividual variability was observed in the oral clearance (CL/F) and the apparent volume of distribution (V/F) of flecainide in the young patients. Flecainide was transported selectively in the basolateral-to-apical direction in P-glycoprotein-expressing renal epithelial LLC-GA5-COL150 cell monolayers. The uptake of flecainide into intestinal epithelial LS180 cells was decreased significantly by acidification of the extracellular medium, and was inhibited by tertiary amines, such as diphenhydramine and quinidine. These findings in the present study suggest that flecainide is excreted by P-glycoprotein in the renal tubule and is taken up by the postulated H(+) /tertiary amine antiporter in the intestine, and that functional variability of not only the hepatic drug-metabolizing enzymes, but also the transporters in the kidney and intestine, may be responsible for the interindividual variability of systemic clearance (CL) and/or the bioavailability (F) of flecainide. Copyright © 2013 John Wiley & Sons, Ltd.
  • Biopharmaceutics & drug disposition.Biopharm Drug Dispos.2014 Apr;35(3):145-53. doi: 10.1002/bdd.1877. Epub 2013 Nov 20.
  • The aims of the present study were to evaluate the variability of pharmacokinetics of flecainide in young Japanese patients and to investigate the mechanisms of renal excretion and intestinal absorption of the drug using cultured epithelial cells. First the plasma concentration data of flecainide wa
  • PMID 24166085

和文文献

  • Successful Radiofrequency Catheter Ablation of a Concealed Anteroseptal Accessory Pathway in a 10-month-old Infant with Refractory Atrioventricular Reentry Tachycardia
  • 藤田 修平,中村 太地,臼田 和生,渡辺 一洋,市田 蕗子,畑崎 喜芳
  • Pediatric Cardiology and Cardiac Surgery 28(2), 136-142, 2012
  • … The tachycardia was refractory to ATP and verapamil injection, per os administration of flecainide and bisoprolol, and frequent cardioversion and intravenous infusion of amiodarone were required. …
  • NAID 130002591125
  • Nonsustained VT in a Patient with Genetically Proven Andersen-Tawil Syndrome (LQT 7)
  • Yasuoka Chie,Tsuchiya Takeshi,Miyamoto Koji,Yamaguchi Takanori,Tanioka Yoshito,Shimizu Wataru
  • Journal of Arrhythmia 27(Supplement), OP16_1, 2011
  • … Combination of oral flecainide (200 mg, bid) and bisoprolol (1.25 mg, qd) remarkably reduced daily number of PVCs/NSVTs to less than 1,000 beats, and rendered exercise-induced bidirectional NSVT before the medication to infrequent PVCs after the medication. … In conclusion, combination of flecainide and bisoprolol suppressed bidirectional VT in an LQT 7 patient. …
  • NAID 130002130498

関連リンク

Find patient medical information for flecainide oral on WebMD including its uses, side effects and safety, interactions, pictures, warnings and user ratings. ... This medication is used to treat certain types of serious (possibly fatal ...
Before taking flecainide, tell your doctor and pharmacist if you are allergic to flecainide or any other medications. tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins ...

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★リンクテーブル★
リンク元フレカイニド」「CAST

フレカイニド」

  [★]

flecainide
酢酸フレカイニド
タンボコール, Tambocor
抗不整脈薬
  • Ic Na+チャネルブロック
  • APD不変
  • 結合解離速度が短い。
  • 連結期の長い期外収縮にも効果があるが正常心拍及び徐脈時の伝導をも阻害 (SPC.240)
  • 心機能低下例:slow kineticsのNa チャネル遮断作用を持つ抗不整脈薬は心機能抑制が強い。したがってフレカイニドは用いられない。 → リドカインメキシレチンアプリンジンアミオダロンニフェカラントを使用。



CAST」

  [★]

cardiac arrhythmia supression trial
抗不整脈薬
  • 抗不整脈薬の役割を明確にするため施行させた大規模臨床試験
心筋梗塞後の心室期外収縮をIc群のencainideflecainideで抑制したところかえって突然死が増加した
→抗不整脈薬の催不整脈作用に対する薬物治療のあり方に変化




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