Morady F, Kou W H, Schmaltz S, Annesley T, De Buitleir M, Nelson S D, Kushner J A
Division of Cardiology, University of Michigan Medical Center, Ann Arbor.
Am J Cardiol. 1988 Jan 1;61(1):93-8. doi: 10.1016/0002-9149(88)91311-2.
No previous studies have determined the pharmaco-dynamics of intravenous procainamide when administered in a dose of 15 mg/kg and at a rate of 50 mg/min, as is common practice during electropharmacologic testing. In this study, 30 patients received procainamide in this fashion; the right ventricular effective refractory period and the QRS duration at a ventricular pacing rate of 120/minute were then determined every minute for 20 minutes. Ten patients received no maintenance infusion of procainamide (group A), 10 received a 4 mg/min maintenance infusion (group B) and 10 received an 8 mg/min maintenance infusion (group C). Ten additional patients received no procainamide and served as control subjects (group D). The plasma procainamide concentration was measured at 1, 5, 10, 15 and 20 minutes after the loading dose was administered. A stable plasma procainamide concentration was not present in group A, B, or C until 15 minutes after infusion of the loading dose. The effective refractory period and QRS duration increased compared with baseline at 1 minute, decreased between 1 and 10 minutes and then remained essentially unchanged between 10 and 20 minutes in all 3 treatment groups. Concentration-effect relation was linear in each treatment group. The plasma procainamide concentrations in group C were significantly greater than in group A; however, the effects on refractoriness and QRS duration were similar in both groups. These findings indicate that with a procainamide dosing method commonly used during electropharmacologic testing, the plasma procainamide concentration decreases significantly during the first 15 minutes after the loading dose is administered.(ABSTRACT TRUNCATED AT 250 WORDS)
既往尚无研究确定在电药理学测试中常用的以15mg/kg的剂量、50mg/min的速率静脉注射普鲁卡因胺时的药效学情况。在本研究中，30例患者按此方式接受了普鲁卡因胺治疗；然后以每分钟120次的心室起搏频率测定右心室有效不应期和QRS时限，共测定20分钟。10例患者未接受普鲁卡因胺维持输注（A组），10例接受4mg/min的维持输注（B组），10例接受8mg/min的维持输注（C组）。另外10例患者未接受普鲁卡因胺治疗，作为对照受试者（D组）。在给予负荷剂量后1、5、10、15和20分钟时测定血浆普鲁卡因胺浓度。直到负荷剂量输注后15分钟，A、B或C组才出现稳定的血浆普鲁卡因胺浓度。在所有3个治疗组中，有效不应期和QRS时限在1分钟时较基线增加，在1至10分钟之间下降，然后在10至20分钟之间基本保持不变。每个治疗组的浓度-效应关系均呈线性。C组的血浆普鲁卡因胺浓度显著高于A组；然而，两组对不应期和QRS时限的影响相似。这些发现表明，采用电药理学测试中常用的普鲁卡因胺给药方法时，在给予负荷剂量后的前15分钟内，血浆普鲁卡因胺浓度会显著下降。（摘要截短至250字）
