Jaillon P
Ann Cardiol Angeiol (Paris). 1984 Dec;33(8):525-30.
The efficacy of antiarrhythmic drug treatment and the risk of toxicity can be evaluated by studying the relationship between these agents effects and their plasma concentrations. Optimal drug surveillance is not possible, however, unless: an effect-concentration relationship can be demonstrated; therapeutic and toxic plasma concentrations have been established; plasma concentrations in different patients demonstrate adequate dosage when measured after the administration of standard doses; a reliable and specific dosing method can be easily performed at a reasonable cost. Lidocaine, quinidine, and procainamide are among the commonly employed antiarrhythmic agents which fulfill all these requirements. Clinical pharmacologic studies are underway for disopyramide, amiodarone, mexiletine, propafenone and flecainide, and certain findings are already of value in hospital settings.
通过研究抗心律失常药物的效应与其血浆浓度之间的关系,可以评估其治疗效果和毒性风险。然而,除非满足以下条件,否则无法进行最佳的药物监测:能够证明效应-浓度关系;已确定治疗性和毒性血浆浓度;在给予标准剂量后测量不同患者的血浆浓度,显示剂量适当;能够以合理成本轻松实施可靠且特异的给药方法。利多卡因、奎尼丁和普鲁卡因酰胺是满足所有这些要求的常用抗心律失常药物。关于丙吡胺、胺碘酮、美西律、普罗帕酮和氟卡尼的临床药理学研究正在进行,某些研究结果在医院环境中已经具有价值。