Terikalant

Terikalant

Terikalant is a novel antiarrhythmic agent primarily used in the management of atrial fibrillation and atrial flutter. It is a member of the class of drugs known as atrial-selective potassium channel blockers, which are designed to target specific ion channels in the heart to restore normal rhythm without affecting ventricular conduction.

Pharmacology

Terikalant works by selectively inhibiting the ultra-rapid delayed rectifier potassium current (IKur) in atrial myocytes. This action prolongs the atrial action potential duration and refractory period, thereby reducing the likelihood of reentrant arrhythmias. Unlike other antiarrhythmic drugs, terikalant has minimal effects on ventricular repolarization, which reduces the risk of ventricular arrhythmias.

Mechanism of Action

The primary mechanism of action of terikalant involves the blockade of the Kv1.5 potassium channels, which are predominantly expressed in atrial tissue. By inhibiting these channels, terikalant prolongs the atrial refractory period without significantly affecting the ventricular myocardium. This atrial selectivity is advantageous in minimizing proarrhythmic risks associated with other non-selective antiarrhythmic agents.

Clinical Use

Terikalant is indicated for the acute conversion of atrial fibrillation to sinus rhythm. It is particularly useful in patients with recent-onset atrial fibrillation, where rapid restoration of sinus rhythm is desired. The drug is administered intravenously, and its effects are typically observed within minutes of administration.

Dosage and Administration

The recommended dose of terikalant is administered as an intravenous infusion over a period of 10 minutes. The dosing regimen may vary based on the patient's weight and renal function. Close monitoring of cardiac rhythm and vital signs is essential during administration.

Side Effects

Common side effects of terikalant include:

• Hypotension
• Bradycardia
• Dizziness
• Nausea

Serious adverse effects are rare but may include:

• Prolonged QT interval
• Torsades de Pointes

Contraindications

Terikalant is contraindicated in patients with:

• Severe heart failure
• Significant electrolyte imbalances
• Known hypersensitivity to the drug

Research and Development

Terikalant is currently undergoing clinical trials to evaluate its efficacy and safety in broader patient populations. Ongoing studies are also exploring its potential use in chronic atrial fibrillation management and its effects on other cardiac arrhythmias.

Also see

• Atrial Fibrillation
• Antiarrhythmic Agents
• Potassium Channel Blockers
• Cardiac Electrophysiology

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