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 9,689 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Intravenous flecainide acetate (2 mg/kg) was administered to 40 patients undergoing routine electrophysiological evaluation for the investigation of recurrent paroxysmal tachycardias. Ten patients had recurrent atrial flutter, 11 patients had recurrent atrial fibrillation, one of whom also had paroxysmal left atrial tachycardia, and 19 patients had recurrent ventricular tachyarrhythmias (17 with recurrent ventricular tachycardia and 2 with recurrent fascicular tachycardia). Flecainide was administered during tachycardia (over 5 to 10 minutes) to all patients with atrial flutter, to 10 patients with atrial fibrillation, and to 17 patients with ventricular tachyarrhythmias. In the remaining 3 patients with ill-sustained arrhythmias flecainide was administered during sinus rhythm and reinitiation of tachycardia was then attempted. Flecainide restored sinus rhythm in only 2 patients with atrial flutter (20%), in 9 patients with atrial fibrillation (90%), in 12 patients with ventricular tachycardia (80%), and in one of the 2 patients with fasicular tachycardia. Flecainide also successfully terminated the left atrial tachycardia. Two patients experienced proarrhythmic side effects during flecainide administration, one of whom required intervention by cardioversion. Minor dose effects included oral paresthesia, transient drowsiness or dizziness, and occasional visual blurring. Flecainide acetate is an effective antiarrhythmic agent for the acute termination of recent onset paroxysmal atrial and ventricular tachyarrhythmias.
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PMID:Intravenous flecainide acetate for the clinical management of paroxysmal tachycardias. 310 95

The chemistry, electrophysiology, pharmacokinetics, clinical use and efficacy, adverse effects, drug interactions, and dosage of encainide hydrochloride and flecainide acetate are reviewed. Encainide and flecainide are class 1c antiarrhythmic agents that slow myocardial conduction and mildly prolong the duration of repolarization. Both agents block anterograde conduction over accessory pathways and prolong the effective refractory period of the accessory pathway. Bioavailability of encainide ranges from 7% to 82%, whereas that of flecainide is 90% to 95%. Encainide is metabolized by the liver to two major active metabolites that are slowly eliminated in the urine. About 23% of flecainide's total body clearance is dependent on renal elimination, and drug excretion is slowed in patients with renal dysfunction, requiring dosage adjustments. Both agents are effective in the suppression and prevention of ventricular arrhythmias, including premature ventricular contractions and sustained and nonsustained ventricular tachycardia. These agents may also be valuable in controlling supraventricular arrhythmias. The most common adverse effects of both agents involve the central nervous system and include dizziness, blurred vision, and headache. The potential for proarrhythmic effects is a concern with these agents. The risk is greater in patients with more severe arrhythmias, poor ventricular function, or high serum concentrations of drug. The usual initial oral dosage of encainide hydrochloride is 25 mg three times a day, with a usual dosage range of 100-200 mg/day. Flecainide acetate should be initiated at 100 mg every 12 hours and may be increased up to 400 mg/day. Encainide and flecainide could become useful therapeutic options in the treatment of a variety of arrhythmias.
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PMID:Encainide hydrochloride and flecainide acetate: two class 1c antiarrhythmic agents. 311 76

The efficacy of flecainide acetate for conversion of atrial fibrillation into sinus rhythm was assessed in 69 patients (mean age of 63 +/- 14 years). Mean duration of the arrhythmia was 49 +/- 45 days. Mean cardiothoracic index was 0.49 +/- 0.03. Flecainide treatment was started intravenously with a bolus of 2 mg/kg over 10 minutes, followed by oral treatment (200 to 300 mg/day) according to body weight. Conversion to sinus rhythm was obtained in 49 patients (71%). The mean delay between initiation of treatment and restoration of sinus rhythm was 301 minutes (range 5 to 1,600). The left atrial diameter was smaller (40 +/- 1 mm) in patients who had successful cardioversion than in those who did not (46 +/- 1 mm) (p less than 0.05). Patients with atrial fibrillation lasting for less than 10 days had a higher conversion rate (79%) than patients with long-standing atrial fibrillation, in whom the conversion rate was only 38% (p less than 0.05). Conversion to sinus rhythm occurred in 33 patients during the first 5 minutes after injection. Adverse effects necessitated discontinuation of treatment in 4 patients (5.8%). Gastrointestinal disorders and dizziness occurred in 5 other patients but did not necessitate discontinuing treatment. In conclusion, flecainide is an effective drug for converting atrial fibrillation into sinus rhythm. Unlike quinidine, flecainide can be administered intravenously. The conversion rate with flecainide is higher in patients with a shorter duration of atrial fibrillation and smaller atria.
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PMID:Restoration of sinus rhythm with flecainide in patients with atrial fibrillation. 313 34

3 parenteral progestogens (medroxyprogesterone acetate, northisterone enanthate, and dehydroxyprogesterone acetophenide with estradiol enanthate, DPA) were studied in 907 women during 14,958 cycles over a 10-year period. The findings are summarized in 9 diagrams. The frequency of the principal side effects - intermenstrual bleeding, amenorrhea, headache, dizziness and nervousness - varied with the different substances. Intermenstrual bleeding and amenorrhea were least serious using DPA. When the injections were administered at the appropriate intervals, the drugs were effective and no pregnancies occurred. After suspending the treatment, the menstrual pattern returned to normal and the endometrium was fully regenerated. To date no fetal abnormalities have been reported after discontinuing the treatment.
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PMID:[Injectable contraceptives. 10 years' clinical experience]. 427 10

The use of depot-type injections of the contraceptive medroxyprogesterone acetate (DMPA) was studied in 1132 women for up to 5 1/2 years. Continuation rates, reasons for discontinuation, method failure rates, and bleeding patterns were considered. The women received a dose of 400 mg DMPA in aqueous suspension (injected into the deltoid muscle) every six months. In addition, each patient received an oral dose of .04 mg ethynl estradiol for 10 days each lunar month. Of the original acceptors, 36.4 percent used the method for the full 5 1/2 years. The major reasons for discontinuation of DMPA injections were bleeding problems (including amenorrhea) and such other medical reasons as palpitation, abdominal pain, headache, weakness, and dizziness. A total of 26 women became accidently pregnant while using DMPA during the 5 1/2 years. Advantages of DMPA injections were the simplicity, safety, and effectiveness of the method, and the psychological appeal of an injectable contraceptive.
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PMID:Use-effectiveness of six-month injections of DMPA as a contraceptive. 482 85

2 experimental contraceptive injection programs are reported. 1 method provides for administration of a combined long-acting estrogen-progestogen product once a month, the other uses a long acting progestogen alone once every 90 days. In the once-a-month injection program in Los Angeles 615 patients representing 871 admissions were studied; treatment data are for both 1st and all admissions. Age distribution was 21-25 years. Patients received 150 mg of progestogen/10 mg estrogen injection. 88.1% reported cycles of 22-30 days/on admission. Some results are: For 1st and all admissions average duration of flow was 6.6 days; for 1st admission group complaints consisted of breast tenderness, 46% dysmenorrhea, 61.8%, weakness or dizziness, 42.8%, local reaction to injection, 37.4%. For all admissions, complaints were: breast tenderness, 43.3%, dysmenorrhea, 59.6%, weakness, 40.2%, local reaction, 33%. Reasons for dropout for both groups included rigidity of protocol, about 52%, moved away, 4.5%, extraneous illness, 1.5%; 64.4% of all admissions discontinued treatment due to unrelated reasons. No pregnancies were reported. The once every 90 day injection of medroxyprogesterone acetate given in doses of 150 mg were given to 243 women, of whom 57% were aged 20-29. Some results are: 1) number of days of bleeding ranged from 6-20 days, 2) 4.6% reported nervousness, 3.4% nausea, 2.1% headaches, 3) main reasons for dropouts were moving away, 11.8%, bleeding, 4.6%, and 4) 1/3 resumed ovulation within 1/2 year. Both methods are found to be extremely effective.
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PMID:Present status of injectable contraceptives: results of seven-years study. 550 12

The antiarrhythmic efficacy and safety of oral flecainide acetate and quinidine sulfate were compared in a double-blind, 16-center parallel trial involving 280 patients with chronic premature ventricular complexes (PVCs). Eighty-five percent of the flecainide patients had at least 80% suppression of PVCs, vs 57% of the quinidine patients (p less than 0.0001). Sixty-eight percent of the flecainide patients met the above criterion and also had complete suppression of couplets and beats of ventricular tachycardia, vs 33% of the quinidine patients (p less than 0.0001). PR and QRS intervals were prolonged by flecainide without clinical consequence, but they were not substantially affected by quinidine (p less than 0.0001). Quinidine prolonged JT (QT minus QRS) intervals significantly more than flecainide (p less than 0.05). Nineteen of 141 flecainide patients and 21 of 139 quinidine patients discontinued therapy because of side effects (p greater than 0.50). Flecainide side effects included dizziness, blurred vision, headache and nausea. Quinidine side effects included diarrhea, nausea, headache and dizziness. Flecainide was more effective than quinidine in suppressing chronic ventricular arrhythmias (especially complex forms), and thus is an important new antiarrhythmic agent.
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PMID:Flecainide versus quinidine for treatment of chronic ventricular arrhythmias. A multicenter clinical trial. 633 10

This case study reports on an obstetric rarity -- an intrauterine and an extrauterine pregnancy of a patient with an IUD in place. The 26-year-old primigravid patient had a previous history of cesarean section for cephalopelvic disproportion. 10 months after the cesarean section a Lippes Loop D was inserted. 2 months after the insertion she was hospitalized for heavy vaginal bleeding following a menstrual delay of 3 weeks. The IUD was shown to be correctly inserted. The uterine cervix was soft and half open. Upon palpation the uterus was found to be enlarged. The probable diagnosis was incomplete spontaneous abortion. IUD removal was followed by curettage. The pathologist's report confirmed the diagnosis of spontaneous abortion. A week after the curettage the patient again complained of scant vaginal bleeding and cramping pain localized in the lower abdomen. She was given ethinyl nortestosterone acetate and ethinyl estradiol for 10 days. After 48 hours of treatment the bleeding stopped. A month later the patient reported copious vaginal bleeding. Another curettage was performed in which several clots were removed. A puncture of the posterior fornix was performed with negative results. Examination of the patient under anesthesia revealed a small mass in the right lower quadrant. The 2nd pathology report on the clots referred to "endometrial tissue with signs of progesterone treatment" without an Arias-Stella image. 5 days after the last curettage the patient was admitted with abdominal pains, vaginal bleeding, weakness, and dizziness. An extrauterine pregnancy was suspected and a laparoscopy was performed. A ruptured right tubal pregnancy was found. A salpingectomy was then performed. Because of the reliability of the patient, it is certain that she did not have intercourse after the 1st curettage. This fact invalidates the possibility of an ectopic pregnancy occurring after her normal pregnancy.
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PMID:Double (uterine and ectopic) pregnancy of a patient using an intrauterine contraceptive device. 646 63

The efficacy, tolerability and impact on quality of life of the ACE inhibitor lisinopril were evaluated in a 12-week open, multicenter post-marketing surveillance study. 233 patients, 45 years and over with diastolic blood pressure (DBP) 95-105 mm Hg were followed after a washout period of 7 days. 22 withdrew due either to adverse reactions, mainly cough (4.3%) and dizziness (3%), or noncompliance. DBP of 90 mm Hg or less was achieved in 50.7% with once-a-day 10 mg lisinopril, in 26.1% with 20 mg and in 16.1% with 20 mg plus addition of hydrochlorothiazide, 12.5 mg; in only 7.1% was BP not controlled. Adverse reactions other than cough or dizziness were experienced by fewer than 1%. Dartmouth COOP Functional Health Assessment Charts/WONCA were used to evaluate quality of life and were found useful in the study. Compared to baseline assessments, all functional status indicators (physical fitness, feelings, daily activities, social activities, change in health and overall health) scored significantly better in all treated patients after 12 weeks. Thus, in more than 90% of patients lisinopril was well-tolerated, highly effective in lowering blood pressure and possibly (no control group) improved the quality of life of all patients.
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PMID:[A multicenter study of lisinopril in the treatment of mild to moderate hypertension]. 755 4

A 50-year-old very obese man had suffered from hypertension for more than 20 years and had undergone various treatment regimens, the last being with an ACE inhibitor. Since his hypertension had nevertheless increased, and he developed dizziness and headaches, a combination of ACE-inhibitor and calcium antagonist was now tried, followed--when this treatment proved unsuccessful--by the fixed-combination preparation containing enalapril plus hydrochlorothiazide. This at last led to a reduction in his blood pressure to approaching normal values, and his subjective symptoms cleared up.
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PMID:[Lowering blood pressure in an obese patient with long-term hypertension. Using a fixed combination of enalapril/hydrochlorothiazide]. 760 92


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