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Efficacy and safety of N ‐acetylprocainamide in long‐term treatment of ventricular arrhythmias
Author(s) -
Atkinson Arthur J,
Lertora Juan J L,
Kushner William,
Chao George C,
Nevin Mary Jane
Publication year - 1983
Publication title -
clinical pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.941
H-Index - 188
eISSN - 1532-6535
pISSN - 0009-9236
DOI - 10.1038/clpt.1983.77
Subject(s) - procainamide , medicine , term (time) , pharmacology , anesthesia , intensive care medicine , physics , quantum mechanics
Four patients with chronic ventricular arrhythmias, shown to respond over the short term to N‐acetylprocainamide (NAPA), were treated for between 3 and 4 yr with NAPA, and 24‐hr ambulatory ECGs were obtained monthly to monitor their responses. When the patients were ambulatory and receiving NAPA, the mean frequency of premature ventricular complexes averaged 70% (range 60% to 82%) below that recorded at 6‐mo intervals when the patients were hospitalized and receiving placebo. Analysis of variance showed that NAPA exerted an antiarrhythmic effect in these patients and that tolerance to this effect did not develop with long‐term therapy. Plasma NAPA concentrations required to achieve this level of response averaged 21 µg/ml (12 to 35 µg/ml) and were roughly twice as high as those which appeared to be maximally effective when the patients were hospitalized for their initial evaluation. NAPA therapy was associated with positive antinuclear antibody titers in only one patient and seems less prone to cause drug‐induced lupus erythematosus than procainamide, but NAPA shares the gastrointestinal and other side effects of procainamide. Clinical Pharmacology and Therapeutics (1983) 33, 565–576; doi: 10.1038/clpt.1983.77