Clinical pharmacology of old and new antiarrhythmic drugs

S. Nattel, D. P. Zipes

Research output: Contribution to journalReview article

4 Scopus citations


The goal of this chapter is to provide information that will aid the physician in the safe and effective use of drug therapy for patients with arrhythmias. Prior to beginning drug therapy, the physician must determine its need by evaluating the nature of the arrhythmia, its severity, and the risks it presents, as well as by excluding reversible disorders such as electrolyte imbalance (hypokalemia and hypomagnesemia), acid-base abnormalities, heart failure, hypoxia, drug toxicity (digitalis, bronchodilators, tricyclic antidepressants, phenothiazines), thyrotoxicosis, and pulmonary disease which can cause or contribute to the development of cardiac arrhythmias. One major feature common to most antiarrhythmic agents is a narrow toxic/therapeutic index. Thus, potentially life-threatening complications of therapy may result from amounts of drug that only slightly exceed the amount necessary to produce beneficial effects. Because subtherapeutic doses of a drug may also be dangerous, by permitting development of a serious arrhythmia, careful dosing with these agents is essential. In order to maintain adequate but nontoxic amounts of drug in the body, one must understand the factors determining drug distribution and elimination.

Original languageEnglish (US)
Pages (from-to)221-248
Number of pages28
JournalCardiovascular Clinics
Issue number1
StatePublished - Dec 1 1980

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    Nattel, S., & Zipes, D. P. (1980). Clinical pharmacology of old and new antiarrhythmic drugs. Cardiovascular Clinics, 11(1), 221-248.