lidocaine – n. 利多卡因
propranolol – n. 普萘洛尔
induce – v. 诱导，引诱
digitalis – n. 洋地黄
catecholamine – n.儿茶酚胺类
bretylium – n. 溴苄铵
Bretylol – n. 托西溴苄铵
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Prototype Drugs 原型药
1. Lidocaine 利多卡因 Indications: Management of acute ventricular arrhythmias during cardiac surgery or MI. 适应症：心脏手术或MI期间急性室性心律不齐的管理 Actions: Decreases depolarization, decreasing automaticity of the ventricular cells; increases ventricular fibrillation threshold. 作用：降低去极化，降低心室细胞自动节律性；增加室颤阈 Pharmacokinetics: 药代动力学
Route Onset Peak Duration
IV 5-10 min 5-10 min 2 h
IV Immediate Immediate 10-20 min
途径 起效 达峰 持续时间
IV 5-10 min 5-10 min 2 h
IV 立即 立即 10-20 min
T1/2: 10 minutes, then 1.5 to 3 hours; metabolized in the liver and excreted in the urine. 半衰期：10 分钟，然后1.5 – 3小时；代谢于肝，随尿排泄。 Adverse Effects: Dizziness, light-headedness, fatigue, arrhythmias, cardiac arrest, nausea, vomiting, anaphylactoid reactions, hypotension, vasodilation. 不良效应：头晕、轻度头痛、疲劳、心律不齐、心搏骤停、恶心、呕吐、过敏性反应、低血压、血管扩张。
2. Propranolol 普萘洛尔 Indications: Treatment of cardiac arrhythmias, especially supraventricular tachycardia; treatment of ventricular tachycardia induced by digitalis or catecholamines. 适应症：心律不剂的治疗，特别是室上性心动过速；洋地黄或儿茶酚胺类诱发性室性心动过速的治疗。 Actions: Competitively blocks beta-adrenergic receptors in the heart and kidney, has a membrane-stabilizing effect, and decreases the influence of the sympathetic nervous system. 作用：竞争性阻断心脏和肾肾上腺素能β受体，具有膜稳定效应，降低交感神经系统影响。 Pharmacokinetics: 药代动力学 Route Onset Peak Duration
Oral 20-30 min 60-90 min 6-12 h
IV Immediate 1 min 4-6 h
途径 超效 达峰 持续时间
口服 20-30 min 60-90 min 6-12 h
IV 立即 1 min 4-6 h T1/2: 3 to 5 hours; metabolized in the liver and excreted in the urine. 半衰期：3-5小时；代谢于肝，随尿排出。 Adverse Effects: Bradycardia, heart failure, cardiac arrhythmias, heart blocks, cerebrovascular accident, pulmonary edema, gastric pain, flatulence, nausea, vomiting, diarrhea, impotence, decreased exercise tolerance, antinuclear antibody development. 不良效应：心搏徐缓，心衰，心律不齐，心脏传导阻滞，脑血管意外，肺水肿，胃痛，胃气胀，恶心，呕吐，腹泻，阳萎，运动耐力下降，出现抗核抗体
————Video ————
Antiarrhythmic Class III-V
————Tests ————
1. Johanna has ventricular ectopy, which of the following drugs is the first line used to treat her condition?
A. Quinidine (Cardioquin)
B. Digoxin (Lanoxin)
C. Procainamide ( Pronestyl)
D. Lidocaine (Xylocaine) 2. Which of the following drugs should be used only in situations in which the client can be very closely monitored, such as a critical care unit?
A. Bretylium (Bretylol)
B. Digoxin (Lanoxin)
C. Quinidine (Cardioquin)
D. Inderal (Propranolol)
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答案 Answer 1. D. Lidocaine (Xylocaine) Rationale: Lidocaine is the only choice used to treat ventricular ectopy. A and C are class Ia antiarrhythmics. Digoxin is a cardiac glycoside. 2. A. Bretylium (Bretylol) Rationale: Among the choices, this is the only agent that must be monitored this closely. B, C, and D are given to outpatients as oral preparations.
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