Horowitz L N, Greenspan A M, Spielman S R, Frye S J, Yacone L A, Lowenthal D T
Clin Pharmacol Ther. 1985 Jun;37(6):644-8. doi: 10.1038/clpt.1985.104.
We evaluated the safety and efficacy of intravenous mexiletine and a method for converting from intravenous to oral mexiletine therapy. Fifteen patients with repetitive ventricular ectopy (13 had ventricular tachycardia) received intravenous mexiletine at a rate of 10 mg/min for 30 to 60 minutes. Ventricular ectopy was suppressed with minimal side effects in 10 of 15 subjects. Oral mexiletine was begun immediately after completion of the intravenous infusion at a dose of 10 mg/kg/24 hr in the 10 responders to intravenous therapy. In eight, the oral dose was effective in suppressing the arrhythmia, but it induced side effects in three of them. In one of these three, dose reduction resulted in adequate arrhythmia control with acceptable toxicity. In the two who did not respond to the original dose, a larger dose (15 mg/kg/24 hr) induced arrhythmia control with acceptable side effects in one subject. Thus rapid control of nonsustained repetitive ventricular arrhythmia can be achieved with intravenous mexiletine in about two thirds of patients, and conversion to oral therapy can often be achieved smoothly without significant arrhythmia recurrence.
我们评估了静脉注射美西律的安全性和有效性以及从静脉注射美西律转换为口服美西律治疗的方法。15例反复性室性早搏患者（13例有室性心动过速）以10mg/分钟的速率静脉注射美西律30至60分钟。15名受试者中有10名受试者的室性早搏得到抑制，且副作用最小。在10名对静脉治疗有反应的受试者中，静脉输注完成后立即开始口服美西律，剂量为10mg/kg/24小时。其中8名患者口服剂量有效地抑制了心律失常，但有3名出现了副作用。在这3名患者中的1名中，减少剂量导致心律失常得到充分控制且毒性可接受。在2名对初始剂量无反应的患者中，较高剂量（15mg/kg/24小时）使1名受试者的心律失常得到控制且副作用可接受。因此，约三分之二的患者静脉注射美西律可快速控制非持续性反复性室性心律失常，并且通常可以顺利转换为口服治疗，而无明显的心律失常复发。
