Tìm theo
Disopyramide
Các tên gọi khác (2) :
  • Disopiramida
  • Disopyramidum
Thuốc chống loạn nhịp
Thuốc Gốc
Small Molecule
CAS: 3737-09-5
ATC: C01BA03
ĐG : Amerisource Health Services Corp. , http://www.amerisourcebergen.com
CTHH: C21H29N3O
PTK: 339.4745
A class I anti-arrhythmic agent (one that interferes directly with the depolarization of the cardiac membrane and thus serves as a membrane-stabilizing agent) with a depressant action on the heart similar to that of guanidine. It also possesses some anticholinergic and local anesthetic properties. [PubChem]
Nhận Dạng Quốc Tế & Đặc Tính Hóa Học
Công thức hóa học
C21H29N3O
Phân tử khối
339.4745
Monoisotopic mass
339.231062565
InChI
InChI=1/C21H29N3O/c1-16(2)24(17(3)4)15-13-21(20(22)25,18-10-6-5-7-11-18)19-12-8-9-14-23-19/h5-12,14,16-17H,13,15H2,1-4H3,(H2,22,25)
InChI Key
InChIKey=UVTNFZQICZKOEM-UHFFFAOYNA-N
IUPAC Name
4-[bis(propan-2-yl)amino]-2-phenyl-2-(pyridin-2-yl)butanamide
Traditional IUPAC Name
disopyramide
SMILES
CC(C)N(CCC(C(N)=O)(C1=CC=CC=C1)C1=NC=CC=C1)C(C)C
Độ tan chảy
94.5-95 °C
Độ hòa tan
44.9 mg/L
logP
2.58
logS
-3.8
pKa (strongest acidic)
16.19
pKa (Strongest Basic)
10.42
PSA
59.22 Å2
Refractivity
102.3 m3·mol-1
Polarizability
38.82 Å3
Rotatable Bond Count
8
H Bond Acceptor Count
3
H Bond Donor Count
1
Physiological Charge
1
Number of Rings
2
Bioavailability
1
Rule of Five
true
Ghose Filter
true
Dược Lực Học : Disopyramide is an antiarrhythmic drug indicated for the treatment of documented ventricular arrhythmias, such as sustained ventricular tachycardia that are life-threatening. In man, Disopyramide at therapeutic plasma levels shortens the sinus node recovery time, lengthens the effective refractory period of the atrium, and has a minimal effect on the effective refractory period of the AV node. Little effect has been shown on AV-nodal and His-Purkinje conduction times or QRS duration. However, prolongation of conduction in accessory pathways occurs.
Cơ Chế Tác Dụng : A class I anti-arrhythmic agent (one that interferes directly with the depolarization of the cardiac membrane and thus serves as a membrane-stabilizing agent) with a depressant action on the heart similar to that of guanidine. It also possesses some anticholinergic and local anesthetic properties. [PubChem] Disopyramide is a Type 1A antiarrhythmic drug (ie, similar to procainamide and quinidine). It inhibits the fast sodium channels. In animal studies Disopyramide decreases the rate of diastolic depolarization (phase 4) in cells with augmented automaticity, decreases the upstroke velocity (phase 0) and increases the action potential duration of normal cardiac cells, decreases the disparity in refractoriness between infarcted and adjacent normally perfused myocardium, and has no effect on alpha- or beta-adrenergic receptors.
Dược Động Học :
▧ Absorption :
Nearly complete
▧ Protein binding :
50%-65%
▧ Metabolism :
Hepatic
▧ Route of Elimination :
In healthy men, about 50% of a given dose of disopyramide is excreted in the urine as the unchanged drug, about 20% as the mono-N-dealkylated metabolite and 10% as the other metabolites.
▧ Half Life :
6.7 hours (range 4-10 hours)
Độc Tính : LD50=580 mg/kg in rats
Chỉ Định : For the treatment of documented ventricular arrhythmias, such as sustained ventricular tachycardia, ventricular pre-excitation and cardiac dysrhythmias. It is a Class Ia antiarrhythmic drug.
Tương Tác Thuốc :
  • Acebutolol Acebutolol may decrease symptoms of hypoglycemia and increase the time required for the body to compensate for hypoglycemia.
  • Artemether Additive QTc-prolongation may occur. Concomitant therapy should be avoided.
  • Atenolol The beta-blocker, atenolol, may increase the toxicity of disopyramide.
  • Azithromycin The macrolide, azithromycin, may increase the effect of disopyramide.
  • Betaxolol The beta-blocker, betaxolol, may increase the toxicity of disopyramide.
  • Bevantolol The beta-blocker, bevantolol, may increase the toxicity of disopyramide.
  • Bisoprolol The beta-blocker, bisoprolol, may increase the toxicity of disopyramide.
  • Butabarbital arbiturates may increase the metabolism of Disopyramide. Monitor for decreased therapeutic effects of disopyramide if a barbiturate is initiated/dose increased, or increased effects if a barbiturate is discontinued/dose decreased.
  • Carteolol The beta-blocker, carteolol, may increase the toxicity of disopyramide.
  • Carvedilol The beta-blocker, carvedilol, may increase the toxicity of disopyramide.
  • Cisapride Increased risk of cardiotoxicity and arrhythmias
  • Clarithromycin Increased risk of cardiotoxicity and arrhythmias
  • Crizotinib Strong CYP3A4 inhibitors may increase levels of crizotinib. Consider alternative therapy.
  • Donepezil Possible antagonism of action
  • Erythromycin Increased risk of cardiotoxicity and arrhythmias
  • Esmolol The beta-blocker, esmolol, may increase the adverse effects of disopyramide.
  • Ethotoin The hydantoin decreases the effect of disopyramide
  • Etravirine Disopyramide, when administered concomitantly with etravirine, may experience a decrease in serum concentration. It is recommended to monitor for disopyramide therapy.
  • Fingolimod Pharmacodynamic synergist. Contraindicated. Increased risk of bradycardia, AV block, and torsade de pointes.
  • Fosphenytoin The hydantoin decreases the effect of disopyramide
  • Galantamine Possible antagonism of action
  • Gatifloxacin Increased risk of cardiotoxicity and arrhythmias
  • Grepafloxacin Increased risk of cardiotoxicity and arrhythmias
  • Insulin Lispro Concomitant therapy with drugs that may increase the blood-glucose-lowering effect of insulin lispro and thus the chance of hypoglycemia should be monitored closely.
  • Labetalol The beta-blocker, labetolol, may increase the toxicity of disopyramide.
  • Levofloxacin Increased risk of cardiotoxicity and arrhythmias
  • Mephenytoin The hydantoin decreases the effect of disopyramide
  • Mesoridazine Increased risk of cardiotoxicity and arrhythmias
  • Metoprolol The beta-blocker, metoprolol, may increase adverse effects of disopyramide.
  • Moxifloxacin Increased risk of cardiotoxicity and arrhythmias
  • Nadolol The beta-blocker, nadolol, may increase the toxicity of disopyramide.
  • Omeprazole The beta-blocker increases toxicity of disopyramide
  • Oxprenolol The beta-blocker, oxprenolol, may increase the toxicity of disopyramide.
  • Penbutolol The beta-blocker, penbutolol, may increase the toxicity of disopyramide.
  • Phenobarbital Phenobarbital decreases levels of disopyramide
  • Phenytoin The hydantoin decreases the effect of disopyramide
  • Pindolol The beta-blocker, pindolol, may increase the toxicity of disopyramide.
  • Practolol The beta-blocker, practolol, may increase the toxicity of disopyramide.
  • Propranolol The beta-blocker, propranolol, may increase the toxicity of disopyramide.
  • Quinupristin This combination presents an increased risk of toxicity
  • Ranolazine Possible additive effect on QT prolongation
  • Rifampicin Rifampin decreases the effect of disopyramide
  • Rivastigmine Possible antagonism of action
  • Sotalol The beta-blocker, sotalol, may increase the toxicity of disopyramide.
  • Sparfloxacin Increased risk of cardiotoxicity and arrhythmias
  • Tacrolimus Additive QTc-prolongation may occur increasing the risk of serious ventricular arrhythmias. Concomitant therapy should be used with caution.
  • Telavancin Additive QTc-prolongation may occur. Concomitant therapy should be avoided.
  • Telithromycin Telithromycin may reduce clearance of Disopyramide. Concomitant therapy should be avoided.
  • Terfenadine Increased risk of cardiotoxicity and arrhythmias
  • Thiopental Thiopental may increase the metabolism and clearance of Disopyramide. Monitor for changes in therapeutic/adverse effects of Disopyramide if Thiopental is inititaed, discontinued or dose changed.
  • Thioridazine Increased risk of cardiotoxicity and arrhythmias
  • Thiothixene May cause additive QTc-prolonging effects. Increased risk of ventricular arrhythmias. Consider alternate therapy. Thorough risk:benefit assessment is required prior to co-administration.
  • Timolol The beta-blocker, timolol, may increase the toxicity of disopyramide.
  • Toremifene Additive QTc-prolongation may occur, increasing the risk of serious ventricular arrhythmias. Consider alternate therapy. A thorough risk:benefit assessment is required prior to co-administration.
  • Trimipramine Additive QTc-prolongation may occur, increasing the risk of serious ventricular arrhythmias. Concomitant therapy should be used with caution.
  • Voriconazole Additive QTc prolongation may occur. Voriconazole, a strong CYP3A4 inhibitor, may also increase the serum concentration of disopyramide by decreasing its metabolism. Consider alternate therapy or monitor for QTc prolongation and changes in the therapeutic and adverse effects of disopyramide if voriconazole is initiated, discontinued or dose changed.
  • Vorinostat Additive QTc prolongation may occur. Consider alternate therapy or monitor for QTc prolongation as this can lead to Torsade de Pointes (TdP).
  • Ziprasidone Additive QTc-prolonging effects may increase the risk of severe arrhythmias. Concomitant therapy should be avoided.
  • Zuclopenthixol Additive QTc prolongation may occur. Consider alternate therapy or use caution and monitor for QTc prolongation as this can lead to Torsade de Pointes (TdP).
Liều Lượng & Cách Dùng : Capsule - Oral
Tablet, extended release - Oral
Dữ Kiện Thương Mại
Giá thị trường
Nhà Sản Xuất
  • Công ty : Sanofi
    Sản phẩm biệt dược : Dicorantil
  • Công ty : SERP
    Sản phẩm biệt dược : Isorythm
  • Công ty : Sawai Seiyaku
    Sản phẩm biệt dược : Lispine
  • Công ty : Pfizer
    Sản phẩm biệt dược : Norpace
  • Công ty : Sanofi
    Sản phẩm biệt dược : Ritmodan
  • Công ty : Sanofi
    Sản phẩm biệt dược : Rythmodan
Đóng gói
Tài Liệu Tham Khảo Thêm
drugbank
http://www.drugbank.ca/drugs/DB00280
KEGG Compound
http://www.genome.jp/dbget-bin/www_bget?cpd:C06965
KEGG Drug
http://www.genome.jp/dbget-bin/www_bget?drug:D00303
National Drug Code Directory
http://www.hipaaspace.com/Medical_Billing/Coding/National.Drug.Codes/PDF/58177-002-04
PharmGKB
http://www.pharmgkb.org/drug/PA449373
Wikipedia
http://en.wikipedia.org/wiki/Disopyramide
RxList
http://www.rxlist.com/cgi/generic2/disopyr.htm
Drugs.com
http://www.drugs.com/cdi/disopyramide.html
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