[Inhibition of QRS-guided pacemakers of the VVI type by skeletal muscle potentials].
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Biomedical subjects
Publications and source records attributed to R Ochotny.
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Pharmacokinetic studies after a single oral dose of 750 mg of PA in 10 normal subjects were performed. In 6 of them, pharmacokinetics of NAPA were also determined after a single oral dose of 900 mg of NAPA. Substantial differences in pharmacokinetic parameters of PA depending on acetylation phenotype were found. In fast acetylators (sulphadimidine phenotyping), half-life was shorter (2.4 +/- 0.7 hr) and 24 hr urine NAPA excretion was larger (22.5 +/- 5.8% of dose) than in slow acetylators (3.6 +/- 1.0 hr and 8.8 +/- 5.4% respectively). NAPA was characterized by different pharmacokinetic parameters (t 1/2 7.0 +/- 1.0 hr, 24 hr urine elimination - 58.5% of dose). Clinical implications of these findings are discussed.
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In 15 patients with coronary heart disease and ventricular arrhythmias 100 mg of procainamide was given intravenously every 5 min until arrhythmia was abolished, or the patient received 1000 mg of the drug, or side-effects appeared. Then patients were placed on oral maintenance therapy 3 or 4 g daily according to their weight. In 13 out of 15 patients arrhythmia was completely suppressed after intravenous injections of the drug. Plasma procainamide concentrations, including N-acetylprocainamide levels in some patients, were monitored and a therapeutic range of 6.3--10.3 microgram/ml for intravenous therapy was found. ECG intervals changes, slowing of heart rate and decrease in systolic and diastolic blood pressure were seen but no serious side-effects were observed. The significance of monitoring plasma drug concentrations, including levels of N-acetylprocainamide during prolonged maintenance therapy, have been discussed.