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FLECAINIDE ACETATE(十)
2013-08-26 22:30:10 来源: 作者: 【 】 浏览:8043次 评论:0
mg/Day (N=426) 300 mg/Day (N=293) 400 mg/Day (N=100)
Dizziness* 18.9% 11.0% 10.6% 13.0%
Visual Disturbances† 15.9% 5.4% 12.3% 18.0%
Dyspnea 10.3% 5.2% 7.5% 4.0%
Headache 9.6% 4.5% 6.1% 9.0%
Nausea 8.9% 4.9% 4.8% 6.0%
Fatigue 7.7% 4.5% 4.4% 3.0%
Palpitation 6.1% 3.5% 2.4% 7.0%
Chest Pain 5.4% 3.1% 3.8% 1.0%
Asthenia 4.9% 2.6% 2.0% 4.0%
Tremor 4.7% 2.4% 3.4% 2.0%
Constipation 4.4% 2.8% 2.1% 1.0%
Edema 3.5% 1.9% 1.4% 2.0%
Abdominal Pain 3.3% 1.9% 2.4% 1.0%

The following additional adverse experiences, possibly related to flecainide therapy and occurring in 1% to less than 3% of patients, have been reported in acute and chronic studies: Body as a Whole: malaise, fever; Cardiovascular: tachycardia, sinus pause or arrest; Gastrointestinal: vomiting, diarrhea, dyspepsia, anorexia; Skin: rash; Visual: diplopia; Nervous System: hypoesthesia, paresthesia, paresis, ataxia, flushing, increased sweating, vertigo, syncope, somnolence, tinnitus; Psychiatric: anxiety, insomnia, depression.

The following additional adverse experiences, possibly related to flecainide, have been reported in less than 1% of patients: Body as a Whole: swollen lips, tongue and mouth; arthralgia, bronchospasm, myalgia; Cardiovascular: angina pectoris, second-degree and third-degree AV block, bradycardia, hypertension, hypotension; Gastrointestinal: flatulence; Urinary System: polyuria, urinary retention; Hematologic: leukopenia, granulocytopenia, thrombocytopenia; Skin: urticaria, exfoliative dermatitis, pruritus, alopecia; Visual: eye pain or irritation, photophobia, nystagmus; Nervous System: twitching, weakness, change in taste, dry mouth, convulsions, impotence, speech disorder, stupor, neuropathy; Respiratory: pneumonitis/pulmonary infiltration possibly due to chronic flecainide treatment; Psychiatric: amnesia, confusion, decreased libido, depersonalization, euphoria, morbid dreams, apathy.

For patients with supraventricular arrhythmias, the most commonly reported noncardiac adverse experiences remain consistent with those known for patients treated with flecainide for ventricular arrhythmias. Dizziness is possibly more frequent in PAF patients.


OVERDOSAGE
No specific antidote has been identified for the treatment of flecainide overdosage. Overdoses ranging up to 8000 mg have been survived, with peak plasma flecainide concentrations as high as 5.3 mcg/mL. Untoward effects in these cases included nausea and vomiting, convulsions, hypotension, bradycardia, syncope, extreme widening of the QRS complex, widening of the QT interval, widening of the PR interval, ventricular tachycardia, AV nodal block, asystole, bundle branch block, cardiac failure, and cardiac arrest. The spectrum of events observed in fatal cases was much the same as that seen in the non-fatal cases. Death has resulted following ingestion of as little as 1000 mg; concomitant overdose of other drugs and/or alcohol in many instances undoubtedly contributed to the fatal outcome. Treatment of overdosage should be supportive and may include the following: removal of unabsorbed drug from the gastrointestinal tract, administration of inotropic agents or cardiac stimulants such as dopamine, dobutamine or isoproterenol; mechanically assisted respiration; circulatory assists such as intra-aortic balloon pumping; and transvenous pacing in the event of conduction block. Because of the long plasma half

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