Prajmaline

Prajmaline.svg

Prajmaline is a pharmaceutical drug used primarily in the treatment of cardiac arrhythmias. It belongs to the class of antiarrhythmic agents known as Class Ia antiarrhythmics, which work by blocking sodium channels in the heart, thereby stabilizing the cardiac cell membrane and reducing excitability.

Mechanism of Action

Prajmaline exerts its effects by inhibiting the fast inward sodium current (INa) during the depolarization phase of the cardiac action potential. This action prolongs the action potential duration and the effective refractory period in the atria, ventricles, and His-Purkinje system. By doing so, it helps to prevent abnormal electrical activity that can lead to arrhythmias.

Indications

Prajmaline is indicated for the management of various types of arrhythmias, including:

• Atrial fibrillation
• Atrial flutter
• Ventricular tachycardia
• Paroxysmal supraventricular tachycardia

Pharmacokinetics

Prajmaline is administered orally and is well-absorbed from the gastrointestinal tract. It undergoes hepatic metabolism and is excreted primarily via the kidneys. The drug has a half-life of approximately 10-12 hours, allowing for twice-daily dosing in most patients.

Side Effects

Common side effects of prajmaline include:

• Dizziness
• Nausea
• Vomiting
• Headache
• Fatigue

Serious side effects may include:

• Proarrhythmia
• Hypotension
• Heart failure

Contraindications

Prajmaline is contraindicated in patients with:

• Second- or third-degree AV block (without a pacemaker)
• Severe heart failure
• Cardiogenic shock
• Known hypersensitivity to prajmaline or any of its components

Drug Interactions

Prajmaline may interact with other medications, including:

• Other antiarrhythmic agents
• Beta-blockers
• Calcium channel blockers
• Digoxin

Monitoring

Patients on prajmaline therapy should be closely monitored for signs of toxicity and effectiveness. Regular ECG monitoring is recommended to assess the drug's impact on cardiac rhythm and to detect any potential proarrhythmic effects.

See Also

• Antiarrhythmic agent
• Cardiac arrhythmia
• Sodium channel blocker

External Links

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