Anti-arrhythmic agents

Another quaternary anti arrhythmic agent is emilium tosyl-ate (65). It is synthesized simply by quaternization of... 

A slightly more complex anti arrhythmic agent is pi rmentol (74). It is synthesized from 4-chloropropiophenone (72) by keto group protection as the dioxolane (with ethylene glycol and acid) followed by sodium iodide-mediated alkylation with cis 2,6-dimethyl pi peri dine to give 7. Deblocking with acid followed by addition of 2-1ithiopyridine completes the synthesis of pi rmentol (74). 

Treatment of the piperidine 74, obtainable from an aminonitrile such as 73, under N-methylation conditions leads to the dimethylamino derivative 75. The carbobenzoxy protecting group is then removed by catalytic hydrogenation. Reaction of the resulting secondary amine 76 with cyclohexene oxide leads to the alkylated trans aminoalcohol. There is thus obtained the anti-arrhythmic agent transcainide (77) [18]. 

Monitor patients for adverse effects of adenosine or any other anti-arrhythmic agents administered (Table 6-6). 

Vardenafil can cause QT-interval prolongation this effect in combination with certain anti-arrhythmic agents can lead to life-threatening arrhythmias. CYP, cytochrome P-450 isoenzyme. 

Which of the following is an anti arrhythmic agent that has relatively few electro physiologic effects on normal myocardial tissue hut suppresses the arrhythmogenic tendencies of ischemic myocardial tissues ... 

A 68-year-old female has AF, which is treated with an anti arrhythmic agent that blocks Na+ channels. On a recent office visit, she complained of recurrent attacks of feeling faint and of experiencing an episode of loss of consciousness. An EKG showed marked prolongation of the QT interval. Plasma concentration of the drug was in the therapeutic range. 

Lidocaine (lignocaine, 4.128, Fig. 4.5) is a typical representative of the class of aminoacylanilides. Lidocaine is a local anesthetic and an anti-arrhythmic agent that is very resistant to chemical hydrolysis even in strongly acidic or basic media. Only at higher temperature does lidocaine... 

Anti-arrhythmic agents Anti-bacterial agents Anti-coagulants Anti-depressants... 

Quinidine Quinidine, molecular formula C20H24N2O2, is a stereoisomer of quinine found in Cinchona bark. Chemically, it is known as (2-ethenyl-4-azabicyclo[2.2.2]oct-5-yl)-(6-methoxyquinolin-4-yl)-methanol, or 6 -methoxycinchonan-9-ol. It is used as a Class 1 anti-arrhythmic agent. Intravenous injection of quinidine is also used in the treatment of P. falciparum malaria. Among the adverse effects, quinidine induces thrombocytopenia (low platelet counts) and may lead to thrombocytic purpurea. 

A given drug may have multiple classes of action. For example, amiodarone shares all four classes of action. Drugs are usually discussed according to the predominant class of action. Certain anti arrhythmic agents, eg, adenosine and magnesium, do not fit readily into this scheme and are described separately. 

Upstroke ends as Na+ channels are rapidly inactivated. Sodium current is blocked by anti-arrhythmic agents, such as quinidine. Cell membrane 1) inactivation of Na+ channels. 2) K+ -channels rapidly open and close causing a transient outward current. Cell membrane... 

Quantification. Gas Chromatography. In serum quinidine and other anti-arrhythmic agents, AFID—K. M. Kessler et aL, Clin. Chem., 1982, 28, 1187-1190. 

High Pressure Liquid Chromatography. In plasma quinidine and other anti-arrhythmic agents, sensitivity 500 ng/ml, UV detection—R. R. Bridges and T. A. Jennison, J. analyt. Toxicol., 1983, 7, 65-68. In plasma quinidine, hydroquinidine, and 2 quinidine metabolites, sensitivity 50 ng/ml for quinidine, fluorescence detection—L. K. Pershing eta/., J. analyt. Toxicol., 1982, 6,153-156. In plasma or urine quinidine, hydroquinidine and quinidine metabolites, detection limit 10 ng/ml for quinidine, fluorescence and UV detection—T. W. Guentert et al., J. Chromat., 1980,183, Biomed. AppL, 9, 514-518. 

Morady F. Prevention of atrial fibrillation in the postoperative cardiac patient significance of oral class III anti-arrhythmic agents. Am J Cardiol 1999 84(9A) R156-60. 

Genunill JD, Howie CA, Meredith PA, Kelman AW, Rasmussen HS, Hillis WS, Elliott HL. A dose-ranging study of UK-68,798, a novel class III anti-arrhythmic agent, in normal volunteers. Br J Clin Pharmacol 1991 32(4) 429-32. 

Sami M, Mason JW, Peters F, Harrison DC. Clinical electrophysiologic effects of encainide, a newly developed anti-arrhythmic agent. Am J Cardiol 1979 44(3) 526-32. 

Myburgh DP, Goldman AP, Schamroth JM. Lorcainide— an anti-arrhythmic agent for ventricular arrhythmias. S Afr Med J 1980 57(7) 236-9. 

Although not subject to hydrolysis, mexiletine hydrochloride is metabolized by oxidative and reductive processes in the liver. Its mctabolitc.s,p-hydroxymexiletineand hydroxy-methylmcxiletine. arc nut pharmacologically active as anti-arrhythmic agents. ... 

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