Propafenone

When ATH:
C01BC03

Characteristic

Colourless crystals or a white crystalline powder with a bitter taste, hardly soluble in water, chloroform and ethanol.

Pharmacological action.
Antiarrhythmic.

Application.

Sustained ventricular tachycardia, life-threatening ventricular arrhythmias, incl. patients with additional ways of excitation (WPW-syndrome, Clerk-levy syndrome-Kristesko).

Contraindications.

Cardiogenic shock, refractory heart failure, sinusovaya bradycardia, sick sinus, hypotension, conduction disorders (sinoatrialnaya, AV blockade II–III century., bundle-branch block), myasthenia, expressed electrolyte imbalance, bronchospasm, severe obstructive pulmonary disease, abnormal liver function or kidney, pregnancy, lactation.

Side effects.

Dizziness, headache, weakness, blurred vision, extrapyramidal disorders, coma, confusion, memory loss, convulsions, noise in ears, nausea, vomiting, disorders of taste sensitivity, anorexia, constipation, dyspepsia, liver damage with increased levels of transaminases, cholestasis, breathlessness, bronchospasm, respiratory arrest, bradycardia, decrease in blood pressure, violation of intraventricular conduction, heart failure, angina, unusual dreams, violation of the emotional sphere, heartbeat, AV block I degrees, extension of the QRS complex, ventricular premature beats, auricular flutter, OF диссоциация, sick sinus, cardiac arrest, agranulocytosis, anemia, Hemorrhagic rash, neutropenia, prolonged bleeding, leukopenia, thrombocytopenia, the appearance of antinuclear antibodies, electrolyte abnormalities, impotence, skin rash, itch.

Cooperation.

Local anesthetics increase the likelihood of CNS. Increases in plasma concentration of cyclosporin, digoksina (It increases the risk of glycoside intoxication). Potentiates the effect of warfarin, blocks biotransformation. Cimetidine and quinidine enhance the blood level of (inhibit its metabolism), rifampicin is reduces. It has the additive electrophysiological and hemodynamic impact of beta-blockers and calcium antagonists. It increases the minimum blood levels of cyclosporine.

Overdose.

Symptoms: convulsions, gipotenziya, bradycardia, intraatrial violations and intraventricular conduction, high grade ventricular arrhythmias, drowsiness or agitation, confusion, extrapyramidal disorder.

Treatment: defibrillation, and isoproterenol infusion dofamina, diazepama, possible ventilator, chest compressions.

Dosing and Administration.

B / drip, inside (after meal, with a small amount of liquid). The usual initial dose inside — 150 mg 3 times / day, in the future it is possible to increase (every 3-4 days) to 225 mg 3 times a day and even before 300 mg 3-4 times a day. The maximum daily dose 1200 mg 4 admission. Children in average dose of 10-20 mg/kg/day in 3-4 reception. B / 0,5 mg / kg, with the subsequent increase to 1-2 mg/kg, with speed 1 mg / min.

Precautions.

Treatment should be under the control of electrolyte balance (particularly potassium levels) and ECG. When extending the PQ interval and QRS complex on expansion 50% and a careful observation of the patient: in case of an increase of more than PQ 0,3 QRS and with more than 0,2 from, occurrence of two-beam block or AV block II-III degree necessary to reduce the dose or stop the drug. It is recommended to periodically determine the activity of transaminases, Antinuclear antibodies. In patients with an implanted pacemaker should consider raising the threshold defibrillation and pacing, Determining bound correction parameters pacemaker. If abnormal liver function (cumulative effect is possible) It is used in doses, 20-30% of normal. Be wary designate drivers of vehicles and persons, employed activity, requiring greater attention and speed of reaction.

Cooperation