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George J Klein - One of the best experts on this subject based on the ideXlab platform.
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a placebo controlled trial of intravenous and oral Disopyramide for prevention of neurally mediated syncope induced by heap up tilt
Journal of the American College of Cardiology, 1993Co-Authors: Carlos A Morillo, James W Leitch, George J KleinAbstract:Objectives. A double-blind randomised trial was designed to determine the efficacy of intravenous and oral Disopyramide Phosphate in preventing neurally syncope induced by a head-up tilt test. Background. Neurally mediated syncope is a frequent cause of syncope and may be induced by head-up tilt, testing. Recent uncontrolled trials have suggested that Disopyramide may be an effective therapy in patients with neurally mediated syncope. Methods. Twenty-two consecutive patients with recurrent neurally mediated syncope and two or successive positive head-up tilt test responses were randomly allocated to receive either intravenous Disopyramide or placebo. Head-up tilt testing at 60 ° was performed for 15 min. If presyncope or syncope was not provoked, isoproterenol infusion was started at a rate of 1 μg/min and the rate gradually increased until a 25% increase in heart rate was achieved. Eleven patients were subsequently randomised in crossover fashion to receive oral disepyramide (800 mg/day) or placebo during 1 week. The primary end point was prevention of syncope or presyncope provoked by head-up tilt testing. Results. Head-up tilt test results were positive for syncope in 12 (75%) of 16 patients receiving intravenous placebo and in 12 (60%) of 20 patients receiving Disopyramide (p = 0.55 Fisher exact test, 95% confidence interval [CI] −14% to 40%). In the intravenous phase, complete crossover was achieved in 15 patients. Head-up tilt test results during this were positive in 13 patients (87%) receiving placebo and in 12 patients (80%) receiving Disopyramide (p = 0.50 Fisher exact test, 95% CI −19% to 32%) and were positive in all patients receiving their initially randomized drug or placebo. In the oral phase, head-up tilt results were positive in only two patients (18%) assigned to placebo and in three patients (27%) receiving Disopyramide (p = 0.54 Fisher exact test, 95% CI −42% to 24%). A mean follow-up time of 29 ± 8 months was obtained in 21 of the 22 patients. Syncope recurred in 3 (27%) of the 11 patients receiving Disopyramide and 3 (30%) of the 10 patients not treated pharmacologically (p > 0.05). Conclusions. Intravenous Disopyramide was ineffective for the prevention of neurally mediated syncope provoked by head-up tilt testing. No significant effect was observed after oral therapy with Disopyramide. There was a striking decrease in the incidence of positive tilt test results over time regardless of intervention, thus discouraging the use of head-up tilt as the single method of assessing therapeutic efficacy. Recurrence of syncope after the investigative protocol was infrequent over long-term follow-up regardless of treatment group.
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a placebo controlled trial of intravenous and oral Disopyramide for prevention of neurally mediated syncope induced by heap up tilt
Journal of the American College of Cardiology, 1993Co-Authors: Carlos A Morillo, James W Leitch, Raymond Yee, George J KleinAbstract:AbstractObjectives. A double-blind randomised trial was designed to determine the efficacy of intravenous and oral Disopyramide Phosphate in preventing neurally syncope induced by a head-up tilt te...
Seibu Mochizuki - One of the best experts on this subject based on the ideXlab platform.
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increased aai mode pacing threshold after termination of atrial fibrillation by acute administration of Disopyramide Phosphate
Europace, 2006Co-Authors: Ryuko Anzawa, Shinichiro Ishikawa, Yasuyuki Tanaka, Fumiko Okazaki, Seibu MochizukiAbstract:Aims We studied changes in atrial pacing threshold after termination of atrial fibrillation (AF) by acute administration of Disopyramide Phosphate (DP) to elucidate the suitable setting for atrial pacing output before AF termination. Methods and results Four patients with sick sinus syndrome implanted with AAI mode pacemakers were examined. Disopyramide Phosphate (2 mg/kg body weight) was injected intravenously for termination of a total of eight AF episodes. The maximal pacing threshold after AF termination (5.2±0.8 V at 0.45 ms) was significantly higher than that at baseline (1.3±0.2 V at 0.45 ms; P <0.01) and the average increment was 433±68%. During a period free from AF, an acute administration of DP did not increase the atrial pacing threshold and serum Disopyramide levels were not toxic. Conclusion The increased atrial pacing threshold observed after AF termination cannot be explained by the action of DP alone. However, our results suggest that atrial pacing output should be set at the maximum value before DP is administered to induce AF termination in patients with AAI pacemaker-dependent bradyarrhythmias.
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atrial pacing failure following termination of atrial fibrillation by acute administration of Disopyramide Phosphate
Journal of Interventional Cardiac Electrophysiology, 2005Co-Authors: Ryuko Anzawa, Shinichiro Ishikawa, Yasuyuki Tanaka, Fumiko Okazaki, Seibu MochizukiAbstract:Atrial pacing failure occurred after termination of atrial fibrillation by acute administration of Disopyramide Phosphate in a 71-year-old woman implanted with an AAI pacemaker for sick sinus syndrome. The atrial pacing threshold showed an 810% increase; however, the serum concentration of Disopyramide corresponded to therapeutic level. Infusion of the same dose of Disopyramide Phosphate used during the period of atrial pacing rhythm did not increase the atrial pacing threshold. In the present patient, we supposed that atrial pacing failure did not occur by the effect of Disopyramide alone, but rather was a reciprocal action in response to atrial fibrillation.
Carlos A Morillo - One of the best experts on this subject based on the ideXlab platform.
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a placebo controlled trial of intravenous and oral Disopyramide for prevention of neurally mediated syncope induced by heap up tilt
Journal of the American College of Cardiology, 1993Co-Authors: Carlos A Morillo, James W Leitch, George J KleinAbstract:Objectives. A double-blind randomised trial was designed to determine the efficacy of intravenous and oral Disopyramide Phosphate in preventing neurally syncope induced by a head-up tilt test. Background. Neurally mediated syncope is a frequent cause of syncope and may be induced by head-up tilt, testing. Recent uncontrolled trials have suggested that Disopyramide may be an effective therapy in patients with neurally mediated syncope. Methods. Twenty-two consecutive patients with recurrent neurally mediated syncope and two or successive positive head-up tilt test responses were randomly allocated to receive either intravenous Disopyramide or placebo. Head-up tilt testing at 60 ° was performed for 15 min. If presyncope or syncope was not provoked, isoproterenol infusion was started at a rate of 1 μg/min and the rate gradually increased until a 25% increase in heart rate was achieved. Eleven patients were subsequently randomised in crossover fashion to receive oral disepyramide (800 mg/day) or placebo during 1 week. The primary end point was prevention of syncope or presyncope provoked by head-up tilt testing. Results. Head-up tilt test results were positive for syncope in 12 (75%) of 16 patients receiving intravenous placebo and in 12 (60%) of 20 patients receiving Disopyramide (p = 0.55 Fisher exact test, 95% confidence interval [CI] −14% to 40%). In the intravenous phase, complete crossover was achieved in 15 patients. Head-up tilt test results during this were positive in 13 patients (87%) receiving placebo and in 12 patients (80%) receiving Disopyramide (p = 0.50 Fisher exact test, 95% CI −19% to 32%) and were positive in all patients receiving their initially randomized drug or placebo. In the oral phase, head-up tilt results were positive in only two patients (18%) assigned to placebo and in three patients (27%) receiving Disopyramide (p = 0.54 Fisher exact test, 95% CI −42% to 24%). A mean follow-up time of 29 ± 8 months was obtained in 21 of the 22 patients. Syncope recurred in 3 (27%) of the 11 patients receiving Disopyramide and 3 (30%) of the 10 patients not treated pharmacologically (p > 0.05). Conclusions. Intravenous Disopyramide was ineffective for the prevention of neurally mediated syncope provoked by head-up tilt testing. No significant effect was observed after oral therapy with Disopyramide. There was a striking decrease in the incidence of positive tilt test results over time regardless of intervention, thus discouraging the use of head-up tilt as the single method of assessing therapeutic efficacy. Recurrence of syncope after the investigative protocol was infrequent over long-term follow-up regardless of treatment group.
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a placebo controlled trial of intravenous and oral Disopyramide for prevention of neurally mediated syncope induced by heap up tilt
Journal of the American College of Cardiology, 1993Co-Authors: Carlos A Morillo, James W Leitch, Raymond Yee, George J KleinAbstract:AbstractObjectives. A double-blind randomised trial was designed to determine the efficacy of intravenous and oral Disopyramide Phosphate in preventing neurally syncope induced by a head-up tilt te...
Mirta Castiñeira Díaz - One of the best experts on this subject based on the ideXlab platform.
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Estabilidad del inyectable de fosfato de disopiramida (13 mg/mL)
Editorial Ciencias Médicas, 2003Co-Authors: Sol Amalia Fernández Monagas, Gisela Gra Ríos, María Aurora Barrios Álvarez, Mirta Castiñeira DíazAbstract:Entre los fármacos utilizados actualmente en el tratamiento de las afecciones cardiovasculares, se encuentran el fosfato de disopiramida, un agente antiarrítmico tipo I, estabilizante del potencial de membrana en reposo. Una de las formas farmacéuticas en que este se presenta es la de inyectable, con una dosificasión de 13 mg/mL para la base, por lo que en este trabajo se realizó el estudio acelerado de estabilidad y el estudio de vida útil de 3 lotes de este innyectable. En las condiciones ensayadas, el medicamento resultó estable, por lo que se propuso una fecha de vencimiento de 2 años.Among the drugs presently used to treat cardiovascular disorders, we may find Disopyramide Phosphate, a type I anti-arrhythmia agent which stabilizes the membrane potential at rest. One of the dosage forms is the injection, at a dose of 13 mg/mL for the basis, therefore, this paper makes an accelerated study of the stability and the analysis of the lifetime of 3 batches of this injectable form. Under the test conditions, the drug turned out to be stable and its expiry date was set at 2 years
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Validación de los métodos analíticos empleados en el estudio del inyectable de fosfato de disopiramida (13 mg/mL)
Editorial Ciencias Médicas, 2003Co-Authors: Gisela Gra Ríos, Sol Amalia Fernández Monagas, Mirta Castiñeira Díaz, María Aurora Barrios ÁlvarezAbstract:Se realizó la validación de un método espectrofotométrico para ser utilizado en el control de la calidad del inyectable fosfato de disopiramida (13 mg/mL), en la que se determinó la absorbancia a 269 nm, y se empleó como disolvente una mezcla de metanol-sulfúrico. También se realizó la validación de una técnica de cromatografía líquida de alta resolución, en la que se utilizó una columna de Lichrosorb RP-8 y como fase móvil una solución de fosfato de sodio monobásico (0,05 mol/L) pH 3:acetonitrilo (73:27 v/v). Ambos métodos resultaron ser lineales, precisos y exactos, en el rango de concentraciones estudiado. Para la técnica de cromatografía líquida de alta resolución se comprobó, además, su especificidad.The validation of an spectrophotometric method, which will be used in the quality control of injectable Disopyramide Phosphate (13 mg/mL), was made in which absorbance was estimated at 269 nm and the dissolvent used was a sulfuric methanol mix. Also, the validation of a high performance liquid chromatography technique was carried out in which a Lichrosorb RP-8 column, and a solution of monobasic sodium Phosphate (0,05 mol/L) ph3: acetonitrile (73:27 v/v) as mobile phase were employed. Both methods turned out to be linear, precise and accurate, within the range of concentrations already studied. Also, this paper proved the specificity of high performance liquid chromatography technique
María Aurora Barrios Álvarez - One of the best experts on this subject based on the ideXlab platform.
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Estabilidad del inyectable de fosfato de disopiramida (13 mg/mL)
Editorial Ciencias Médicas, 2003Co-Authors: Sol Amalia Fernández Monagas, Gisela Gra Ríos, María Aurora Barrios Álvarez, Mirta Castiñeira DíazAbstract:Entre los fármacos utilizados actualmente en el tratamiento de las afecciones cardiovasculares, se encuentran el fosfato de disopiramida, un agente antiarrítmico tipo I, estabilizante del potencial de membrana en reposo. Una de las formas farmacéuticas en que este se presenta es la de inyectable, con una dosificasión de 13 mg/mL para la base, por lo que en este trabajo se realizó el estudio acelerado de estabilidad y el estudio de vida útil de 3 lotes de este innyectable. En las condiciones ensayadas, el medicamento resultó estable, por lo que se propuso una fecha de vencimiento de 2 años.Among the drugs presently used to treat cardiovascular disorders, we may find Disopyramide Phosphate, a type I anti-arrhythmia agent which stabilizes the membrane potential at rest. One of the dosage forms is the injection, at a dose of 13 mg/mL for the basis, therefore, this paper makes an accelerated study of the stability and the analysis of the lifetime of 3 batches of this injectable form. Under the test conditions, the drug turned out to be stable and its expiry date was set at 2 years
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Validación de los métodos analíticos empleados en el estudio del inyectable de fosfato de disopiramida (13 mg/mL)
Editorial Ciencias Médicas, 2003Co-Authors: Gisela Gra Ríos, Sol Amalia Fernández Monagas, Mirta Castiñeira Díaz, María Aurora Barrios ÁlvarezAbstract:Se realizó la validación de un método espectrofotométrico para ser utilizado en el control de la calidad del inyectable fosfato de disopiramida (13 mg/mL), en la que se determinó la absorbancia a 269 nm, y se empleó como disolvente una mezcla de metanol-sulfúrico. También se realizó la validación de una técnica de cromatografía líquida de alta resolución, en la que se utilizó una columna de Lichrosorb RP-8 y como fase móvil una solución de fosfato de sodio monobásico (0,05 mol/L) pH 3:acetonitrilo (73:27 v/v). Ambos métodos resultaron ser lineales, precisos y exactos, en el rango de concentraciones estudiado. Para la técnica de cromatografía líquida de alta resolución se comprobó, además, su especificidad.The validation of an spectrophotometric method, which will be used in the quality control of injectable Disopyramide Phosphate (13 mg/mL), was made in which absorbance was estimated at 269 nm and the dissolvent used was a sulfuric methanol mix. Also, the validation of a high performance liquid chromatography technique was carried out in which a Lichrosorb RP-8 column, and a solution of monobasic sodium Phosphate (0,05 mol/L) ph3: acetonitrile (73:27 v/v) as mobile phase were employed. Both methods turned out to be linear, precise and accurate, within the range of concentrations already studied. Also, this paper proved the specificity of high performance liquid chromatography technique