Flecainide

그림문자(GHS)

• 그림문자(GHS)

  

• 신호 어

  Danger

• 유해·위험 문구

  H225：고인화성 액체 및 증기

  H370：장기(또는, 영향을 받은 알려진 모든 장기를 명시)에 손상을 일으킴(노출되어도 특정 표적장기 독성을 일으키지 않는다는 결정적인 노출경로가 있다면 노출경로를 기재)

• 예방조치문구

  P210：열·스파크·화염·고열로부터 멀리하시오 - 금연 하시오.

  P260：분진·흄·가스·미스트·증기·...·스프레이를 흡입하지 마시오.

  P280：보호장갑/보호의/보안경/안면보호구를 착용하시오.

  P301+P310：삼켰다면 즉시 의료기관(의사)의 진찰을 받으시오.

  P311：의료기관(의사)의 진찰을 받으시오.

Flecainide 화학적 특성, 용도, 생산

• 개요

  From the chemical point, flecainide is an analog of procainamide, to which a 2.2.2-trifluoroethoxyl group was added at C2 and C3 of the benzene ring, and a diaminoethyl side chain is ended in the piperidine ring.

• 화학적 성질

  White Crystalline Powder

• 용도

  Flecainide, as with other local anesthetics, is used for naturally occurring ventricular arrhythmia.

• 정의

  ChEBI: A monocarboxylic acid amide obtained by formal condensation of the carboxy group of 2,5-bis(2,2,2-trifluoroethoxy)benzoic acid with the primary amino group of piperidin-2-ylmethylamine. An antiarrhythmic agent used (in the form of its acetate salt) to prev nt and treat tachyarrhythmia (abnormal fast rhythm of the heart).

• World Health Organization (WHO)

  The membrane-stabilizing antiarrhythmic agent flecainide was introduced into medicine in 1982. The decision to delete the indications for patients with asymptomatic and less severe symptomatic ventricular arrhythmias was taken on the basis of the results of a trial (CAST study) that showed a two-fold increase in deaths in post-myocardiac patients taking flecainide compared with the placebo group.

• 위험도

  Human systemic effects.

• Clinical Use

  Flecainide (Tambocor) is a fluorinated aromatic hydrocarbon examined initially for its local anesthetic action and subsequently found to have antiarrhythmic effects. Flecainide inhibits the sodium channel, leading to conduction slowing in all parts of the heart, but most notably in the His-Purkinje system and ventricular myocardium. It has relatively minor effects on repolarization. Flecainide also inhibits abnormal automaticity.
  Flecainide is effective in treating most types of atrial arrhythmias. It is also used for life-threatening ventricular arrhythmias. However, flecainide should be used with extreme caution in any patient with structural heart disease. Flecainide crosses the placenta, with fetal levels reaching approximately 70% of maternal levels. In many centers, it is the second-line drug after digoxin for therapy of fetal arrhythmias. Because of the high incidence of proarrhythmia, initiation of therapy or significant increases in dosing should be performed only on inpatients.

• 부작용

  Most adverse effects occur within a few days of initial drug administration. The most frequently reported effects are dizziness, light-headedness, faintness, unsteadiness, visual disturbances, blurred vision (e.g., spots before the eyes, difficulty in focusing), nausea, headache, and dyspnea.
  Worsening of heart failure and prolongation of the PR and QRS intervals are likely to occur with flecainide, and an increased risk of proarrhythmia has been reported.

• Drug interactions

  In patients whose condition has been stabilized by flecainide, the addition of cimetidine may reduce the rate of flecainide’s hepatic metabolism, increasing the potential for toxicity. Flecainide may increase digoxin concentrations on concurrent administration.

• 주의 사항

  Flecainide is contraindicated in patients with preexisting second- or third-degree heart block or with bundle branch block unless a pacemaker is present to maintain ventricular rhythm. It should not be used in patients with cardiogenic shock.

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