抗心律失常药的评价与联合用药

EVALUATION ON ANTIARRHYTHMIA AGENTS AND THEIR COMBINATION USE

胺碘酮为广谱抗心律失常药,对预防阵发性房颤,对顽固性室性或室上性心律失常效果较好:心律平优于奎尼丁;异搏定静注对室上性心动过速疗效显著;艾司洛尔和氟司洛尔(flestolol)急救时应用最好;索他洛尔(Sotalol)为有前途的广谱抗心律失常药;安搏律定神经系统副作用较重;双异丙吡胺抑制心肌副作用较大。对于顽固性心律失常临床上常需联合用药,但联合用药也可能带来毒副反应。

Amiodarone,a broad spectrum antiarrhythmia,exhibits favourable theraputic effects in preventing paraxymal atrial fibrillation and in treatment of persistent ventricular tachycardia.Propafenone has a better antiarrhythmia effect than quinidin,iv administration of Isoptin manifests significant effect in treatment of ven-tricular tachycardia.Esmolol and flestolol are the best agents for emergency cases.Sotalol is a promising broad spectrum agent for treatment of arrhythmia.Aprindineand Disopyramide possess side effect of nervous system for the former and myocardiumdepressing for the later.Combination use of these agents is often needed for treatmentof persistent arrhythmia but toxic effects may be occured.