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Antiarrhythmic Drugs - Mechanisms of Antiarrhythmic and Proarrhythmic Actions (Paperback, Softcover reprint of the original 1st ed. 1995)
Loot Price: R2,966
Discovery Miles 29 660
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Antiarrhythmic Drugs - Mechanisms of Antiarrhythmic and Proarrhythmic Actions (Paperback, Softcover reprint of the original 1st ed. 1995)
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The past 10 years have seen a remarkable change in the approach to
cardiac arrhythmias, from a position of confidence and a feeling of
well-being about pharmacological treatment to a situation in which
there is now marked uncertainty and general apprehension about the
role of antiarrhythmic drugs. Until relatively recently the
prevailing concept in antiarrhythmic therapy was that arrhythmias
could be controlled by drugs which slowed conduction or suppressed
automaticity, goals well served by the sodium channel-blocking
drugs and glycosides. Drug re search was based largely on the
development of agents mimicking those already available, but with
greater efficacy, fewer side effects or a more favourable phar
macokinetic profile. The CAST trial stands out as a landmark in the
evolution of arrhytmia manage ment; rarely has a single trial had
such a profound impact not only on clinical prac tice, but also on
the whole approach of those involved in the research, development
and regulation of antiarrhythmic drugs. The results of the CAST
trial, designed to redress the shortcomings of earlier trials which
had failed to demonstrate the anticipated improvement in mortality
post-myocardial infarction with the use of class I agents, are well
known. The CAST and CAST II showed an increase in mor tality
associated with the active agent (encainide, flecainide or
morizicine) com pared to placebo treatment. They firmly established
the potential danger in the use of class I drugs."
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