Description overdue on 30.03.2012

Antiarrhythmics . The main active component - procainamide . The active ingredient has a membrane stabilizing effect. It is based on rapid deceleration, the incoming flow of sodium ions, reducing the rate of depolarization in phase zero. Novokainamid slows repolarization It inhibits conductivity, reduces the excitability of the myocardium of the ventricles, atria. Under the action of the drug is increased while the effective refractory period of the action potential (to a greater extent in tissue affected myocardium). Procainamide has vasodilating and vagolytic action that causes a drop in blood pressure tachycardia . Procainamide manufactured as a solution, tablet.

Indications:

Novokainamid prescribed for atrial flutter , Tachycardia, ventricular arrhythmia, ventricular fibrillation, atrial arrhythmia, WPW syndrome , Atrial fibrillation.

Contraindications:

Novokainamid not prescribed for leukopenia, arrhythmia in overdose cardiac glycosides , AV block grade 2-3, procainamide intolerance. In SLE, kidney disease, liver systems   myasthenia , Myocardial infarction, arrhythmia in overdose glycosides form decompensated heart failure, hypertension, total atherosclerosis, asthma, the elderly and QT prolongation novokainamid used with caution.

Side effect:

Nervous system: ataxia , Psychotic reactions, convulsions, dizziness, hallucinations, myasthenia gravis, depression, and headaches. Perhaps oppression medullary hematopoiesis, the taste, hemolytic anemia , Leukopenia, ventricular paroxysmal tachycardia, drop in blood pressure, asystole, conduction disturbances (atrial, intraventricular). Long-term use may cause lupus erythematosus   drug genesis. Among the side effects may develop thrombocytopenia, microbial infections, difficulty in wound healing.

Overdose:

It is characterized by severe dizziness, oliguria , Drowsiness, fainting, confusion, vomiting, tachycardia, asystole, paroxysmal tachycardia, loss of appetite, diarrhea, AV block, collapse, drop in blood pressure. Requires the introduction of phenylephrine, norepinephrine in the fall in blood pressure. Effective hemodialysis, gastric lavage, the appointment of agents acidifying the urine.

Mode of application:

Novokainamid administered intramuscularly, intravenously, taken orally. Intravenous: procainamide 100mg sodium chloride dissolved in 0, 9%, administered slowly, the rate of not more than 50mg per minute is required pressure control. In some cases, to achieve the effect you want to re-infusion of the same dose every five minutes. To prevent recurrent arrhythmia were infused at a speed of 2-6 mg per minute. After arresting arrhythmic episode achieved effect is maintained intramuscular dose procainamide 0, 5-1 gram, but preferred embodiment of administration - orally, intravenously. Procainamide hydrochloride sustained-release tablets: If supraventricular arrhythmia maintenance dose is 1 gram every six hours. Ventricular arrhythmias: every six hours, 50 mg / kg / day.

Special instructions:

Novokainamid take on an "empty stomach", desired time of reception - two hours after a meal or one hour before bedtime. Tablets are washed down with water, milk. Solution prior to intravenous administration must be diluted. Procainamide therapy involves control of blood pressure, ECG, white blood cell count, the state of the peripheral blood. Following a long-term therapy in 80% of patients recorded elevated levels of antinuclear antibodies titer. Long-term use of the drug prolonged action novokainamid after surgical interventions on the heart leads to the development of leukopenia. Elderly patients may develop hypotension . Children need to assign higher doses compared to the therapeutic dosage. Assigning pregnant women leads to an increased risk of hypotension mothers that causes the utero-placental insufficiency. Novokainamid affects concentration, transport management.

Drug Interactions:

Procainamide increases the effects of muscle relaxants, anticholinergics, cytostatic agents, antihypertensive drugs. Atropine effects are amplified when taken with antihistamine agents. QT prolongation is recorded when taking procainamide a pimozodom. Novokainamid intensifies the side effects of bretylium tosylate, inhibits the action of antimiastenicheskih funds. The risk of developing mielosupression   increases in prescribing that inhibit the function of bone marrow. The probability of formation of arrhythmogenic effect is increased with concomitant administration with antiarrhythmics third grade. The half-life novokainamida increases and decreases renal clearance while taking cimetidine.