Tocainid Chemische Eigenschaften,Einsatz,Produktion Methoden
R-Sätze Betriebsanweisung:
R22:Gesundheitsschädlich beim Verschlucken.
Verwenden
Tocainide is used for suppressing symptoms of ventricular arrhythmia and tachycardia,
and for premature cardiac contractions.
Definition
ChEBI: A monocarboxylic acid amide in which 2,6-dimethylphenylaniline and isobutyric acid have combined to form the amide bond; used as a local anaesthetic.
Weltgesundheitsorganisation (WHO)
Tocainide, an antidysrhythmic agent, was introduced in 1981 for
the treatment of ventricular dysrhythmias. By 1984 its use was associated with
cases of agranulocytosis, aplastic anaemia and thrombocytopenia, some of which
were fatal. This led some regulatory authorities to restrict the indications for its
use. The major manufacturer has subsequently restricted its use on a worldwide
basis to the treatment of symptomatic ventricular dysrhythmias not responding to
other therapy, or when other therapy is contraindicated.
Pharmakokinetik
The α-methyl group is believed to slow the rate of metabolism and, thereby, to
contribute to oral activity. The plasma half-life of tocainide is approximately 12 hours, and nearly
50% of the drug may be excreted unchanged in the urine. Adverse effects associated with tocainide
are like those observed with lidocaine—specifically, gastrointestinal disturbances and central
nervous system effects.
Clinical Use
Tocainide (Tonocard) is an orally effective antiarrhythmic
agent with close structural similarities to lidocaine. Tocainide is indicated for the treatment of symptomatic
ventricular arrhythmias refractory to more conventional
therapy. Serious noncardiac adverse effects limit its use
to patients with life-threatening arrhythmias.
Nebenwirkungen
Light-headedness, dizziness, or nausea occurs in approximately
15% of patients, paresthesias and numbness
in 9%, and tremor in 8%.These adverse effects are
generally mild in intensity, transient, and dose related.
Overall, however, approximately 20% of patients prescribed
tocainide discontinue therapy because of such
effects. Serious immune-based side effects, such as pulmonary
fibrosis, have been reported, and blood
dyscrasias, such as agranulocytosis and thrombocytopenia,
may occur in up to 0.2% of patients.
Arzneimittelwechselwirkung
When used with other class IB antiarrhythmic drugs, tocainide
toxicity may be increased without significant
gain in antiarrhythmic efficacy.
Vorsichtsmaßnahmen
Patients who are hypersensitive to tocainide or to local
anesthetics of the amide type should not be exposed to
tocainide.The presence of second- or third-degree heart
block in the absence of an artificial pacemaker also contraindicates
the use of tocainide.
Tocainid Upstream-Materialien And Downstream Produkte
Upstream-Materialien
Downstream Produkte
