McMahon M T, Sheaffer S L
Drug Intell Clin Pharm. 1982 Jun;16(6):443-7. doi: 10.1177/106002808201600601.
Verapamil is a calcium antagonist that is pharmacologically different from other currently marketed antiarrhythmics. It is used for the acute treatment of PSVT and atrial fibrillation and flutter. It appears to be more effective than beta-adrenergic blocking agents in the treatment of PSVT. Approximately 80 percent of patients with PSVT will convert to normal sinus rhythm after verapamil 0.075-0.15 mg/kg. Atrial fibrillation and flutter seldom convert to sinus rhythm with verapamil, but it successfully reduces the ventricular rate in 90 percent of these patients. Verapamil is useful for the rapid conversion of PSVT to normal sinus rhythm and for the rapid control of ventricular rate in atrial fibrillation and flutter before other antiarrhythmics have taken effect. Because of its short plasma half-life, other agents or cardioversion can be used if verapamil is unsuccessful. The use of verapamil in the treatment of classical and variant angina, hypertrophic cardiomyopathy, and hypertension is being evaluated. Mild reduction in blood pressure and heart rate may occur with verapamil therapy. Caution must be exercised when verapamil is administered to patients with sinus node disease, advanced AV block, concomitant beta-adrenergic blocking agents, and digitalis intoxication.
维拉帕米是一种钙拮抗剂，在药理作用上与目前市面上其他抗心律失常药物不同。它用于室上性心动过速（PSVT）、心房颤动和心房扑动的急性治疗。在治疗PSVT方面，它似乎比β肾上腺素能阻滞剂更有效。约80%的PSVT患者在静脉注射0.075 - 0.15mg/kg维拉帕米后可转为正常窦性心律。维拉帕米很少能使心房颤动和心房扑动转为窦性心律，但能使90%的此类患者心室率成功降低。在其他抗心律失常药物起效前，维拉帕米有助于将PSVT快速转为正常窦性心律，并能快速控制心房颤动和心房扑动时的心室率。由于其血浆半衰期短，如果维拉帕米治疗无效，可使用其他药物或进行心脏电复律。维拉帕米在经典型和变异型心绞痛、肥厚型心肌病及高血压治疗中的应用正在评估中。维拉帕米治疗可能会导致血压和心率轻度降低。给患有窦房结疾病、严重房室传导阻滞、正在服用β肾上腺素能阻滞剂以及洋地黄中毒的患者使用维拉帕米时必须谨慎。
