Cardiovascular effects of doxepin in cardiac patients with ventricular arrhythmias.
Cardiovascular effects of doxepin in cardiac patients with ventricular arrhythmias.
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多虑平对室性心律失常心脏病患者的心血管作用。
DOI：
10.1038/clpt.1987.102
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发表时间：
1987
影响因子：
6.7
通讯作者：
Saroff,AL
中科院分区：
文献类型：
--
作者：
Giardina,EG;Cooper,TB;Suckow,R;Saroff,AL
在一项剂量范围方案中，在10例有频繁室性早搏症状的心脏病患者中评价多塞平对室性心律失常、ECG和左心室功能的影响。4例患者（40%）的室性早搏除极抑制≥80%; 4/8例成对室性心动过速和4/6例室性心动过速患者的抑制≥90%。平均最大多塞平剂量为115 ± 41 mg/天;平均最低总多塞平浓度为61 ± 48 ng/ml，平均最低总去甲基多塞平浓度为51 ± 42 ng/ml。多塞平使心率及体表心电图PR、QRS、QTc间期增加（P无显著性差异）。多塞平组静息时平均左心室射血分数无显著变化：41% ± 15% vs. 43% ± 19%（P无显著性）。镇静投诉（八名患者）限制了剂量范围和对药物的耐受性。虽然多塞平抑制了4名患者的室性早搏，但明显的镇静作用限制了其在该人群心律失常的主要治疗中的作用。
The effect of doxepin on ventricular arrhythmias, the ECG, and left ventricular function was evaluated in 10 cardiac patients with symptoms with frequent ventricular premature depolarizations in a dose‐ranging protocol. Four patients (40%) had ≥80% ventricular premature depolarization suppression; four of eight with pairs and four of six with ventricular tachycardia had ≥90% suppression. The mean maximal doxepin dose was 115 ± 41 mg/day; mean nadir total doxepin concentration was 61 ± 48 ng/ml and mean nadir total desmethyldoxepin concentration was 51 ± 42 ng/ml. Doxepin increased the heart rate and the PR, QRS, and QTc intervals of the surface ECG (P not significant). There was no significant change in resting mean left ventricular ejection fraction with doxepin: 41% ± 15% vs. 43% ± 19% (P not significant). Complaints of sedation (eight patients) limited dose ranging and tolerance to the drug. Although doxepin suppressed ventricular premature depolarizations in four patients, marked sedation limits its usefulness for primary treatment of arrhythmias in this population.Clinical Pharmacology and Therapeutics(1987)42,20–27; doi:10.1038/clpt.1987.102