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Related Experiment Videos

Tocainide kinetics in congestive heart failure.

S M Mohiuddin, D Esterbrooks, D E Hilleman

    Clinical Pharmacology and Therapeutics
    |November 1, 1983
    PubMed
    Summary

    Oral tocainide effectively treated ventricular arrhythmias in patients unresponsive to other drugs. However, tocainide plasma concentrations did not predict patient response or adverse reactions, necessitating further research for optimal dosing.

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    Area of Science:

    • Pharmacology
    • Cardiology
    • Clinical Therapeutics

    Background:

    • Ventricular arrhythmias pose significant life-threatening risks.
    • Standard oral antiarrhythmic drugs are not always effective.
    • Intravenous lidocaine can be effective but is not suitable for long-term oral therapy.

    Purpose of the Study:

    • To evaluate the efficacy and pharmacokinetics of oral tocainide in patients with refractory ventricular arrhythmias.
    • To determine if tocainide plasma concentrations correlate with therapeutic response or adverse events.
    • To establish patient-specific kinetic parameters for predicting tocainide concentrations.

    Main Methods:

    • Twenty patients with refractory ventricular arrhythmias were treated with oral tocainide.
    • Plasma tocainide concentrations were measured during initial therapy to calculate pharmacokinetic parameters.

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  • Steady-state concentrations were predicted using patient-specific kinetic data.
  • Dosing regimens were adjusted based on age, weight, and clinical status.

    • Main Results:

    • Oral tocainide was effective in managing ventricular arrhythmias.
    • Mean daily tocainide dose was 1800 mg.
    • Tocainide plasma concentrations did not correlate with response or adverse reactions.
    • A trend towards higher plasma concentrations in patients with congestive heart failure was observed.

    Conclusions:

    • Oral tocainide is a viable treatment option for refractory ventricular arrhythmias.
    • Current pharmacokinetic parameters and plasma concentrations do not reliably predict patient outcomes.
    • Further studies are needed to refine tocainide dosing strategies, especially in patients with heart failure.