Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0151744 (myocardial ischemia)
 31,282 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Mexiletine is a new local anaesthetic antiarrhythmic agent whose chemical structure and electrophysiological properties closely resemble those of lignocaine although its anticonvulsant and pharmacokinetic properties differ from that drug. Unlike lignocaine (lidocaine) it is active following oral administration with a plasma half-life varying between 8 and 20 hours so that it can be administered twice or three times daily to sustain therapeutic plasma levels. The drug is effective when given intravenously or by the oral route in controlling ventricular arrhythmias especially following acute myocardial infarction but the side effects are greater during parenteral administration. Side effects during chronic oral therapy with mexiletine have not posed a serious problem. Mexiletine has the pharmacodynamic and pharmacokinetic properties of an agent suitable for the chronic oral prophylaxis of serious ventricular arrhythmias in patients with ischaemic heart disease.
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PMID:Mexiletine: a review of its pharmacological properties and therapeutic efficacy in arrhythmias. 37 46

This study was performed to evaluate the effects of antiarrhythmic drugs on left ventricular function in 843 patients with ischaemic heart disease and ventricular arrhythmias (Lown classes 2-5). Rhythm abnormalities were observed by ambulatory electrocardiographic monitoring before and after 2-weeks of antiarrhythmic therapy. Haemodynamic variables such as cardiac output (CO), ejection fraction (EF), stroke volume (SV), and ratio of myocardial contractility (RMC) were derived from the cross sectional echocardiography. Efficacy of the applied drugs was 42-71%. Of these antiarrhythmic agents only propranolol caused the deterioration of left ventricular performance, measured by CO; in mono-therapy propranolol produced significant changes (p less than 0.05), in combination with amiodarone--at point of significance. Mexiletine produced significant improvement in EF and SV (p less than 0.05). There were no significant changes in haemodynamic parameters after treatment with the other drugs.
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PMID:[Effects of antiarrhythmic drugs on some echocardiographic parameters of left ventricular function in patients with ischemic heart disease]. 207 48

Fifty-one patients were treated with mexiletine over 10.4 +/- 16 months. The clinical arrhythmia in 25 (49%) was ventricular fibrillation (VF), 11 (22%) had sustained ventricular tachycardia (VT), and 15 (29%) had symptomatic nonsustained VT. Ischemic heart disease was present in 33 patients (66%), cardiomyopathy in nine (17%), and valvular or congenital heart disease in nine (17%). Only six (12%) remain on the drug. Arrhythmias recurred in 21 patients (41%): seven (14%) with VF, three (5%) with sustained VT, and 11 (22%) with symptomatic nonsustained VT. Intolerable side effects occurred in another 17 (33%). Seven patients (14%) died from nonarrhythmic-related deaths while taking mexiletine. Mexiletine was combined with a conventional type IA antiarrhythmic agent in 25 patients (49%). In 12 of these 25 patients (48%), ventricular arrhythmias recurred. These findings were not significantly different from those of the group treated with mexiletine alone, where arrhythmias recurred in 9 of 26 patients (35%) (p = NS). Thus mexiletine, alone or in combination with a type IA antiarrhythmic agent, has limited clinical utility in patients with life-threatening ventricular arrhythmias.
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PMID:Intolerance and ineffectiveness of mexiletine in patients with serious ventricular arrhythmias. 373 84

The present study has been carried out on 50 patients admitted to C.C.U. for cardiovascular diseases of various ethiology (44 patients with ischemic heart disease) who required antiarrhythmic theory for different types of ventricular arrhythmias: monofocal ventricular extrasistoles greater than 6/min, bigeminal ventricular extrasistoles, polifocal and/or repetitive ventricular tachycardias. The patients have been randomly allocated into two groups of 25 subjects: the first one has been treated with Mexiletine and the second with Lidocaine. In Mexiletine treated group the following results have been obtained: 19 excellent (76%), 4 good (16%) and 2 ineffective (8%). In Lidocaine treated group: 11 excellent (44%), 5 good (20%) and 9 ineffective (36%). Statistical analysis by chi square test has shown significant prevalence of favourable results in Mexiletine treated patients (p less than 0.02; X(2) = 5.33). Moreover, in relation to the type of arrhythmias, Mexiletine succeded in a greater number of cases of complicated ventricular extrasistoles (bigeminal, polifocal and/or ripetitive) and in ventricular tachicardias. Mexiletine also has induced significant reduction of QTc and significant increase of cardiac rate, whereas it did not affect significantly the PR interval and blood pressure. None of these parameters has been influenced significantly by Lidocaine. Side effects have been similar for both drugs and generally mild. On the basis of results and in accord with the electrophysiological properties, the Authors discuss the possible mechanism of action and the role of Mexiletine in the treatment of ventricular arrhythmias particularly those complicating acute phase of myocardial infarction.
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PMID:[Comparative study of the anti-arrhythmic activity of mexiletine and lidocaine in ventricular hyperkinetic arrhythmias]. 616 78